Individual
JENNIFER LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
8114 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372
(718) 505-9401
Mailing address
8114 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-6746
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
008814
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2018
Last updated
06/28/2018
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