Mr Jaekwan Lee, | |
16213 46th Ave Ste 3b, Flushing, NY 11358-3698 | |
(929) 362-7708 | |
Not Available |
Full Name | Mr Jaekwan Lee |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 16213 46th Ave Ste 3b, 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 |
---|---|---|---|
1417512203 | NPI | - | NPPES |
1528671146 | Other | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 041462 (New York) | Primary |
Provider Name | J Lee Physical Therapy Pc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1528671146 PECOS PAC ID: 0840606505 Enrollment ID: O20210304002080 |
Mailing Address | Practice Location Address |
---|---|
Mr Jaekwan Lee, 4362 162nd Street, 2nd Floor, Flushing, NY 11358 Ph: (929) 362-7708 | Mr Jaekwan Lee, 16213 46th Ave Ste 3b, Flushing, NY 11358-3698 Ph: (929) 362-7708 |
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