Provider Demographics
NPI:1447811336
Name:LEE PODIATRY PLLC
Entity type:Organization
Organization Name:LEE PODIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAE
Authorized Official - Middle Name:YONG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:917-832-0408
Mailing Address - Street 1:5 ANDERSON ST APT 201
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-6454
Mailing Address - Country:US
Mailing Address - Phone:917-832-0408
Mailing Address - Fax:
Practice Address - Street 1:12 N 7TH AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2026
Practice Address - Country:US
Practice Address - Phone:914-361-6918
Practice Address - Fax:914-664-2873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-22
Last Update Date:2019-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric