Lee, Jung Lack
Lee, Jung Lack is an sole proprietor health care provider with primary practice located at 143-25A Roosevelt Ave. , Flushing NY 11354. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Lee, Jung Lack can be contacted via phone (718) 353-0505.Contact Information
Primary practice address
143-25A Roosevelt Ave.
Flushing NY 11354
Phone: (718) 353-0505
Fax: (718) 966-2576
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 144342 | New York |
Profile Details
| NPI number | 1457394306 |
|---|---|
| LBN Legal business name | Lee, Jung Lack |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Nov 4th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457394306 | NPPES |
| New York | MEDICAID | 00823818 |
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