| Sung Won Lee Md Pc | |
|
101 Broad Ave Palisades Park NJ 07650-1438 | |
| (201) 941-2486 | |
| (201) 941-1577 |
| Full Name | Sung Won Lee Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 101 Broad Ave, Palisades Park, New Jersey |
| Authorized Official Name and Position | Sungwon Lee (PRESIDENT) |
| Authorized Official Contact | 2019412486 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sung Won Lee Md Pc 101 Broad Ave Palisades Park NJ 07650-1438 Ph: (201) 941-2486 | Sung Won Lee Md Pc 101 Broad Ave Palisades Park NJ 07650-1438 Ph: (201) 941-2486 |
| NPI Number | 1144501362 |
|---|---|
| Provider Enumeration Date | 09/01/2011 |
| Last Update Date | 10/24/2011 |
| Medicare PECOS PAC ID | 9931360716 |
|---|---|
| Medicare Enrollment ID | O20120423000545 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144501362 | NPI | - | NPPES |
| 0093572 | Medicaid | NJ |
| Provider Name | Sung Won Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144296492 PECOS PAC ID: 0648293878 Enrollment ID: I20060113000084 |
| Provider Name | Suyon Yim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922564749 PECOS PAC ID: 3476886896 Enrollment ID: I20190617002708 |
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