Provider Demographics
NPI:1144816547
Name:LEE, HEE SUNG
Entity type:Individual
Prefix:
First Name:HEE SUNG
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7353 LITTLE RIVER TPKE UNIT A
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3305
Mailing Address - Country:US
Mailing Address - Phone:703-941-0200
Mailing Address - Fax:
Practice Address - Street 1:7353 LITTLE RIVER TPKE UNIT A
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3305
Practice Address - Country:US
Practice Address - Phone:703-941-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician