Individual
CHEONG EUN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
85 W BURNSIDE AVE, BRONX, NY 10453-4015
(718) 716-4400
Mailing address
111 HICKS ST, APT 9Q, BROOKLYN, NY 11201-1658
(248) 462-5792
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
056667
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03622520
—
NY
Enumeration date
03/13/2012
Last updated
10/31/2016
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