Individual
JAE YOON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13124 ROCKAWAY BLVD, SOUTH OZONE PARK, NY 11420-2932
(718) 659-7166
Mailing address
518 VALLEYVIEW PL, STATEN ISLAND, NY 10314-5535
(718) 983-9777
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
164410
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00995955
—
NY
Enumeration date
08/28/2006
Last updated
10/03/2013
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