Individual
KEAT-JIN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 LONG WHARF DR, SUITE 302, NEW HAVEN, CT 06511-5991
(203) 777-4005
(203) 776-7741
Mailing address
1 LONG WHARF DR, SUITE 302, NEW HAVEN, CT 06511-5991
(203) 777-4005
(203) 776-7741
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
015233
CT
207YX0602X
Otolaryngic Allergy Physician
015233
CT
207YX0901X
Otology & Neurotology Physician
015233
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001152339
—
CT
01
—
041069592
RAILROAD MEDICARE PIN
CT
Enumeration date
07/21/2006
Last updated
07/02/2009
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