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Individual

MR. JAE SUNG LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5300 MILITARY RD, MOUNT ST MARYS HOSPITAL, LEWISTON, NY 14092
(716) 297-4800
Mailing address
5290 MILITARY RD, STE 6, LEWISTON, NY 14092
(716) 297-2998

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
130958
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00589579
NY
Enumeration date
02/07/2006
Last updated
09/09/2010
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