Provider Demographics
NPI:1992892871
Name:LEE, MEN-JEAN (MD)
Entity type:Individual
Prefix:
First Name:MEN-JEAN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 ALA MOANA BLVD
Mailing Address - Street 2:STE 1001
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5419
Mailing Address - Country:US
Mailing Address - Phone:808-469-4900
Mailing Address - Fax:808-536-9059
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:801
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-203-6580
Practice Address - Fax:808-951-1637
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192472207V00000X, 207VM0101X
HIMD 18707207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01421012Medicaid
NY03J101Medicare PIN
NY01421012Medicaid