Individual
YO SUP LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2501 PARKERS LANE, ALEXANDRIA, VA 22306-3209
(703) 664-7048
Mailing address
68 S SERVICE RD, STE 350, MELVILLE, NY 11747-2358
(516) 945-3000
(516) 985-3131
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0001186693
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700921590
—
VA
05
—
416240401
—
MD
Enumeration date
02/20/2007
Last updated
03/23/2015
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