Yeo Jin Lee, AGPCNP-BC
Individual provider Active NPI Primary Care Nurse Practitioner · Demarest, NJ
NPI 1194601245 · NPPES record last updated Aug 14, 2025
Key facts
- NPI
- 1194601245
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 2024061398 (NY)
- Practice address
- 83 Holland Ave
Demarest, NJ 07627-2706 - Phone
- (551) 574-2382
- NPI assigned
- Aug 14, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024061398 | NY | MD | Primary Care Nurse Practitioner |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 2024061398 | NY | Yes |
Addresses
Primary practice location
83 Holland Ave
Demarest, NJ 07627-2706
Mailing address
83 Holland Ave
Demarest, NJ 07627-2706
Phone (551) 574-2382
Other providers in Demarest, NJ
- Lindsay Brooke Kestenbaum
- Ruth B Klebansky
- Valerie Klebansky
- Knickerbocker Chiropractic Centre
- Seungyi Sophia Lee
- Dana Bach Lindbloom
- Emmett Charles Line
- Madison Medical Supplies
- Michi Nutrition
- Sonal R Modi
All providers in Demarest, NJ · Primary Care Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.