Provider Demographics
NPI:1366959199
Name:LEE, HYEIN KATHY (CPNP-AC)
Entity type:Individual
Prefix:MS
First Name:HYEIN KATHY
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:CPNP-AC
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPNP-AC
Mailing Address - Street 1:6 STUYVESANT OVAL APT 9B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2418
Mailing Address - Country:US
Mailing Address - Phone:310-502-1560
Mailing Address - Fax:
Practice Address - Street 1:3959 BROADWAY
Practice Address - Street 2:11C PICU
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-305-3281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-02
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF431205-1363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care