Individual
JUNG LACK LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
143-25A ROOSEVELT AVE., FLUSHING, NY 11354
(718) 353-0505
(718) 966-2576
Mailing address
341 POWELL ST., STATEN ISLAND, NY 10312
(718) 966-6000
(718) 966-2576
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
144342
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00823818
—
NY
Enumeration date
06/14/2006
Last updated
11/04/2014
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