Basic Information
Provider Information
NPI: 1750744454
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEE
FirstName: BELINDA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 COMMUNITY DR
Address2:  
City: MANHASSET
State: NY
PostalCode: 110303816
CountryCode: US
TelephoneNumber: 5165620100
FaxNumber:  
Practice Location
Address1: 27005 76TH AVE
Address2:  
City: NEW HYDE PARK
State: NY
PostalCode: 110401402
CountryCode: US
TelephoneNumber: 7184707000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/30/2016
LastUpdateDate: 10/21/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/21/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X298567NYY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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