Provider Demographics
NPI:1841889243
Name:HYUNSEOK LEE, DPT
Entity type:Organization
Organization Name:HYUNSEOK LEE, DPT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:HYUNSEOK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:347-886-8584
Mailing Address - Street 1:810 ABBOTT BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-4116
Mailing Address - Country:US
Mailing Address - Phone:201-514-1452
Mailing Address - Fax:201-523-5423
Practice Address - Street 1:810 ABBOTT BLVD STE 104
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-4116
Practice Address - Country:US
Practice Address - Phone:201-514-1452
Practice Address - Fax:201-523-5423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-12
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty