Individual
JOHN HYUP LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000524
PA
152WC0802X
Corneal and Contact Management Optometrist
OEG000524
PA
152WP0200X
Pediatric Optometrist
OEG000524
PA
152WX0102X
Occupational Vision Optometrist
OEG000524
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017197
AETNA - GROUP NUMBER
PA
01
—
367529
HIGHMARK BLUE SHIELD GROU
PA
01
—
5914492
AETNA - INDIVIDUAL
PA
01
—
785692
HIGHMARK BLUE SHIELD INDI
PA
Enumeration date
02/13/2006
Last updated
06/12/2014
Update your record
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