Seonjoong Lee, | |
13338 41st Rd Ste Cs8, Flushing, NY 11355-3662 | |
(201) 815-3969 | |
Not Available |
Full Name | Seonjoong Lee |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 13338 41st Rd Ste Cs8, Flushing, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003546540 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 040285 (New York) | Primary |
Provider Name | Lenox Hill Pain Management And Spine Pllc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1063865111 PECOS PAC ID: 4082902234 Enrollment ID: O20161004002016 |
Mailing Address | Practice Location Address |
---|---|
Seonjoong Lee, 75 Montgomery St Apt 18c, New York, NY 10002-6551 Ph: (201) 815-3969 | Seonjoong Lee, 13338 41st Rd Ste Cs8, Flushing, NY 11355-3662 Ph: (201) 815-3969 |
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