Jae Eun Lee

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F309262-01 Issued in NY

Practice address

444 Willis Ave
Bronx, NY 10455-4013

Phone

(347) 862-2700

NPI assigned

Jun 16, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• K & L Wellness NP PC

  • Adult Health Nurse Practitioner
  • Bayonne, NJ
  • NPI 1154216000
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1073834784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 WILLIS AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104554013",
            "telephone_number": "347-862-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 WILLIS AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104554013",
            "telephone_number": "347-862-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAE EUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-16",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "620172",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309262-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gladys Lee, M.D.
• Hangyul Lee
• Harrison Sunjoon Lee, MD
• Hyejung Lee
• Hyojeong Lee
• Jaeni Lee
• Jai Il Lee, PHARMD
• James Lee, MD
• Janet Lee
• Janet Jeonghwa Lee, BSC , DDS

• Adult Health Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.