Provider Demographics
NPI:1215689195
Name:LEE, BINNA (LAC, MPH)
Entity type:Individual
Prefix:
First Name:BINNA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LAC, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 N CENTRE AVE APT 123
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3950
Mailing Address - Country:US
Mailing Address - Phone:516-522-9370
Mailing Address - Fax:
Practice Address - Street 1:80 N CENTRE AVE APT 123
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3950
Practice Address - Country:US
Practice Address - Phone:516-522-9370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-22
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005818171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist