Provider Demographics
NPI:1063524619
Name:LEE, EUN HA (MD)
Entity type:Individual
Prefix:
First Name:EUN
Middle Name:HA
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EUNHA
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:601 ELMWOOD AVE BOX 664
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-5321
Mailing Address - Fax:
Practice Address - Street 1:10 HAGEN DRIVE
Practice Address - Street 2:SUITE #330, ROCHESTER GENERAL MEDICAL GROUP
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2661
Practice Address - Country:US
Practice Address - Phone:585-922-8350
Practice Address - Fax:585-586-1813
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251695208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation