Lee, Clara Taeyoon

Lee, Clara Taeyoon is an individual health care provider with primary practice located at 82-68 164Th St N Building Room 633, Queens NY 11432. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Lee, Clara Taeyoon can be contacted via phone (718) 883-3000.

Contact Information

Primary practice address
82-68 164Th St N Building Room 633 Queens NY 11432
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X NA New York

Profile Details

NPI number 1942761648
LBN Legal business name Lee, Clara Taeyoon
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2019
Last updated Apr 30th, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942761648 NPPES
Other NA NA

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