Basic Information
| Provider Information | |||||||||
| NPI: | 1326078460 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14 CLARENDON PL | ||||||||
| Address2: | |||||||||
| City: | SCARSDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105832418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6468729515 | ||||||||
| FaxNumber: | 9149480041 | ||||||||
| Practice Location | |||||||||
| Address1: | 2422 CENTRAL PARK AVE | ||||||||
| Address2: | |||||||||
| City: | YONKERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107101125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147792995 | ||||||||
| FaxNumber: | 9147793266 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 227375 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208100000X | 227375 | NY | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 02644806 | 05 | NY | MEDICAID |