Provider Demographics
NPI:1588866271
Name:LEE, HYUN JOON (MD)
Entity type:Individual
Prefix:DR
First Name:HYUN JOON
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOON
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2 OVERHILL RD STE 260
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5334
Mailing Address - Country:US
Mailing Address - Phone:914-722-9440
Mailing Address - Fax:914-722-9441
Practice Address - Street 1:2 OVERHILL RD STE 260
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583
Practice Address - Country:US
Practice Address - Phone:914-722-9440
Practice Address - Fax:914-722-9441
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT57295207Q00000X
NY229053207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I00439Medicare UPIN