Lee, Jack

Lee, Jack is an individual health care provider with primary practice located at 245 Union Ave 2C, Bridgewater NJ 08807-3064. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Lee, Jack can be contacted via phone (908) 722-5115.

Contact Information

Primary practice address
245 Union Ave 2C Bridgewater NJ 08807-3064
Phone: (908) 722-5115
Fax: (908) 722-9515
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1083675318
LBN Legal business name Lee, Jack
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Feb 6th, 2015 - about 9 years 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 1083675318 NPPES
New Jersey MEDICAID 0058947

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