Individual
MS. JIN AH LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
34 BLACKPINE DR, MEDFORD, NY 11763-4103
(551) 486-3142
Mailing address
34 BLACKPINE DR, MEDFORD, NY 11763-4103
(551) 486-3142
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
310383-1
NY
Other
Enumeration date
11/01/2012
Last updated
11/01/2012
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