Individual
MISS JAEJUNG LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 TILLARY ST, BROOKLYN, NY 11201-3026
(718) 855-7485
(718) 855-1317
Mailing address
200 W 89TH ST, APT. 3W, NEW YORK, NY 10024-1847
(714) 331-7205
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402313
NY
390200000X
Student in an Organized Health Care Education/Training Program
679880
NY
Other
Enumeration date
07/25/2016
Last updated
03/17/2018
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