Basic Information
| Provider Information | |||||||||
| NPI: | 1992013528 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | YOHAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 651 OLD COUNTRY RD | ||||||||
| Address2: | |||||||||
| City: | PLAINVIEW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 118034938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166818822 | ||||||||
| FaxNumber: | 5166813332 | ||||||||
| Practice Location | |||||||||
| Address1: | 651 OLD COUNTRY RD | ||||||||
| Address2: | |||||||||
| City: | PLAINVIEW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 118034938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166818822 | ||||||||
| FaxNumber: | 5166813332 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2010 | ||||||||
| LastUpdateDate: | 08/19/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0014X | MD453198 | PA | Y | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | 208VP0000X | MD453198 | PA | N | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | 2081P2900X | MD453198 | PA | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine | 208VP0014X | 25MA09579200 | NJ | N | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | 208VP0000X | 25MA09579200 | NJ | N | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | 2081P2900X | 25MA09579200 | NJ | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine |
No ID Information.