Provider Demographics
NPI:1174120802
Name:LEE, YOONYOUNG (DACM, LAC, DIPLOM)
Entity type:Individual
Prefix:DR
First Name:YOONYOUNG
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DACM, LAC, DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 N MIDDLETOWN RD # 1G-A
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1188
Mailing Address - Country:US
Mailing Address - Phone:201-753-2330
Mailing Address - Fax:
Practice Address - Street 1:275 N MIDDLETOWN RD # 1G-A
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-1188
Practice Address - Country:US
Practice Address - Phone:929-373-4072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006724171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist