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Dr. Edward Choongho Lee
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NPI Number Detailed Information
Provider Information:
| Name: | Dr. Edward Choongho Lee |
| Gender: | M |
| Provider License Number If Given: | 199158-1 |
NPI Information:
| NPI: | 1124012620 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 9/12/2005 |
| Last Update Date: | 7/8/2007 |
Provider Business Mailing Address:
| Address: | 47 NEW SCOTLAND AVE Albany, NY 12208 |
| Phone Number: | 5182625623 |
| Fax Number: | 5182625560 |
Provider Business Practice Location Address:
| Address: | 47 NEW SCOTLAND AVE Albany, NY 12208 |
| Phone Number: | 5182625623 |
| Fax Number: | 5182625560 |
Provider Taxonomy:
| Primary: | 208600000X |
| Secondary (if any): | 208C00000X |
| State: | NY |
