Lee, Tracy Jae Won

Lee, Tracy Jae Won is an individual health care provider with primary practice located at 120 Mineola Blvd Ste 10 Lower Level, Mineola NY 11501-4073. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Body Imaging. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Lee, Tracy Jae Won can be contacted via phone (516) 663-4510.

Contact Information

Primary practice address
120 Mineola Blvd Ste 10 Lower Level Mineola NY 11501-4073
Phone: (516) 663-4510
Fax: (516) 663-3698
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 230112 New York
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X 230112 New York

Profile Details

NPI number 1386688984
LBN Legal business name Lee, Tracy Jae Won
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Jul 8th, 2007 - about 17 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 1386688984 NPPES
New York MEDICAID 02730436

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