Basic Information
| Provider Information | |||||||||
| NPI: | 1407038763 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | YOON | ||||||||
| MiddleName: | KYOUNG | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | R.N | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 AARON CT | ||||||||
| Address2: | |||||||||
| City: | BRIDGEWATER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088075681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9085950234 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 151 KNOLLCROFT RD | ||||||||
| Address2: | NHCU 1B | ||||||||
| City: | LYONS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079395001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9086470180 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2007 | ||||||||
| LastUpdateDate: | 11/28/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 26NR09286200 | NJ | Y | Nursing Service Providers | Registered Nurse |
No ID Information.