Provider Demographics
NPI:1548660582
Name:LEE, HYUNSEOK (DPT)
Entity type:Individual
Prefix:
First Name:HYUNSEOK
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:810 ABBOTT BLVD
Mailing Address - Street 2:STE 104
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-4116
Mailing Address - Country:US
Mailing Address - Phone:201-514-1452
Mailing Address - Fax:201-523-5423
Practice Address - Street 1:810 ABBOTT BLVD
Practice Address - Street 2:STE 104
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-4116
Practice Address - Country:US
Practice Address - Phone:201-514-1452
Practice Address - Fax:201-523-5423
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01566300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist