Provider Demographics
NPI:1306095195
Name:WOOLEONARD, CHOON LEE
Entity type:Individual
Prefix:
First Name:CHOON LEE
Middle Name:
Last Name:WOOLEONARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8534 60TH DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-5432
Mailing Address - Country:US
Mailing Address - Phone:718-440-1556
Mailing Address - Fax:
Practice Address - Street 1:8534 60TH DR
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-5432
Practice Address - Country:US
Practice Address - Phone:718-440-1556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY50287061252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency