Provider Demographics
NPI:1992984900
Name:KEVIN S. LEE, M.D. & STEPHEN S. LEE, M.D.,PC
Entity type:Organization
Organization Name:KEVIN S. LEE, M.D. & STEPHEN S. LEE, M.D.,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-321-9090
Mailing Address - Street 1:2704 PARSONS BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-1343
Mailing Address - Country:US
Mailing Address - Phone:718-321-9090
Mailing Address - Fax:718-661-3330
Practice Address - Street 1:2704 PARSONS BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-1343
Practice Address - Country:US
Practice Address - Phone:718-321-9090
Practice Address - Fax:718-321-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186405207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01665998Medicaid
NY02141GHMedicare Oscar/Certification
NY01665998Medicaid