Individual
HYUN-SOO LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14472 NORTHERN BLVD STE 203, FLUSHING, NY 11354-4231
(718) 886-9000
Mailing address
4012 80TH ST STE 5A, ELMHURST, NY 11373-1234
(718) 886-9000
(718) 961-0666
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MA66379
NJ
207ND0900X
Dermatopathology Physician
186672
NY
207NP0225X
Pediatric Dermatology Physician
186672
NY
207NS0135X
Procedural Dermatology Physician
186672
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01761279
—
NY
05
—
7458703
—
NJ
Enumeration date
10/26/2006
Last updated
03/01/2022
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