| Doctor Name: | KYUNG MIN LEE |
| NPI Number: | 1083904874 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | 26NJ00326000 |
| Business Practice Address: | 230 W Parkway #10 Pompton Plains, NJ - 074441060 |
| Business Phone Number: | 9738350800 |
| Business Fax Number: | |
| Mailing Address: | 230 W Parkway, #10 POMPTON PLAINS |
| State: | NJ |
| Postal Code: | 074441060 |
| Phone Number: | 9738350800 |
| Fax Number: | |
| NPI Enumeration Date: | 04/13/2011 |
| NPI Last Update Date: | 06/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | 26NJ00326000 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |