Basic Information
Provider Information
NPI: 1851538441
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEE
FirstName: ERIC
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 285 DAVIDSON AVE STE 204
Address2:  
City: SOMERSET
State: NJ
PostalCode: 088734153
CountryCode: US
TelephoneNumber: 7322711400
FaxNumber: 7322713544
Practice Location
Address1: 285 DAVIDSON AVE STE 204
Address2:  
City: SOMERSET
State: NJ
PostalCode: 088734153
CountryCode: US
TelephoneNumber: 7322711400
FaxNumber: 7322713544
Other Information
ProviderEnumerationDate: 01/19/2009
LastUpdateDate: 07/02/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LP3000X25MA08816500NJY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology

No ID Information.


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