Lee, Jae Yoon

Lee, Jae Yoon is an individual health care provider with primary practice located at 13124 Rockaway Blvd , South Ozone Park NY 11420-2932. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Lee, Jae Yoon can be contacted via phone (718) 659-7166.

Contact Information

Primary practice address
13124 Rockaway Blvd South Ozone Park NY 11420-2932
Phone: (718) 659-7166
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 164410 New York

Profile Details

NPI number 1609984814
LBN Legal business name Lee, Jae Yoon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2006
Last updated Oct 3rd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609984814 NPPES
New York MEDICAID 00995955

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