Provider Demographics
NPI:1538236989
Name:LEE, STEVEN T (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:T
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 ROCK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2310
Mailing Address - Country:US
Mailing Address - Phone:973-784-3654
Mailing Address - Fax:
Practice Address - Street 1:HACKETTSTOWN REGIONAL MEDICAL CENTER,
Practice Address - Street 2:DEPT.ADVANCED DIAG IMAGING, 651 WILLOW GROVE ST.
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840
Practice Address - Country:US
Practice Address - Phone:908-850-6842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA069813002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01948627Medicaid
NJ01948627Medicaid