Active NPI
Minsun Lee, PH.D.
- Psychologist
- Maywood, NJ
National Provider Identifier
1215336938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35SI00559300
- Practice address
- 87 Rte 17 N
Maywood, NJ 07607 - Phone
- (551) 996-3216
- NPI assigned
- Aug 19, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 020795 | NY | |
| Psychologist | 103T00000X | 35SI00559300 | NJ | Primary |
Addresses
Primary practice location
87 Rte 17 N
Maywood, NJ 07607
Mailing address
87 Rte 17N
Maywood, NJ 07607
Phone (551) 996-3216
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00559300 | NJ | MD | Psychologist |
| 020795 | NY | MD | Hospitalist Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553731200000",
"number": "1215336938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87 RTE 17N",
"city": "MAYWOOD",
"state": "NJ",
"postal_code": "07607",
"telephone_number": "551-996-3216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87 RTE 17 N",
"city": "MAYWOOD",
"state": "NJ",
"postal_code": "07607",
"telephone_number": "551-996-3216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MINSUN",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-19",
"last_updated": "2019-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "020795",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "35SI00559300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maywood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.