| Doctor Name: | TRACY JAE WON LEE |
| NPI Number: | 1386688984 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 230112 |
| Business Practice Address: | 120 Mineola Blvd Ste 10 Lower Level Mineola, NY - 115014073 |
| Business Phone Number: | 5166634510 |
| Business Fax Number: | 5166633698 |
| Mailing Address: | Gpo Box 27686, NEW YORK |
| State: | NY |
| Postal Code: | 100877686 |
| Phone Number: | 8882201235 |
| Fax Number: | 8654509374 |
| NPI Enumeration Date: | 06/15/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | 230112 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |