Individual
JOHN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
891 IONIA AVE, STATEN ISLAND, NY 10309-2307
(646) 234-4908
Mailing address
891 IONIA AVE, STATEN ISLAND, NY 10309-2307
(646) 234-4908
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
214576-1
NY
207L00000X
Anesthesiology Physician
25MA07112100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02700163
—
NY
Enumeration date
12/14/2005
Last updated
10/01/2014
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