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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

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