Individual
BRIAN W LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2333 MORRIS AVE STE B105, UNION, NJ 07083-5716
(908) 686-8764
Mailing address
2142 UTOPIA PKWY, WHITESTONE, NY 11357-4142
(718) 819-6800
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR008001000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46TR008001000
LICENSE
NJ
Enumeration date
11/06/2017
Last updated
11/06/2017
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