Provider Demographics
NPI:1063917235
Name:LEE, JIM CHUNHAO (MD,MPH)
Entity type:Individual
Prefix:
First Name:JIM
Middle Name:CHUNHAO
Last Name:LEE
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
Other - First Name:CHUN HAO
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVENUE
Mailing Address - Street 2:BOX 626
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-3191
Mailing Address - Fax:585-273-3637
Practice Address - Street 1:601 ELMWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-3191
Practice Address - Fax:585-273-3637
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY323610207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology