Provider Demographics
NPI:1730467929
Name:LEE, JEUNG-EUN (ARNP)
Entity type:Individual
Prefix:
First Name:JEUNG-EUN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 7TH AVE STE 5A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3691
Mailing Address - Country:US
Mailing Address - Phone:718-246-8700
Mailing Address - Fax:718-246-8701
Practice Address - Street 1:263 7TH AVE STE 2B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3693
Practice Address - Country:US
Practice Address - Phone:718-246-8700
Practice Address - Fax:718-246-8705
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS75219207RC0000X
NYF3384471363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease