Active NPI
Fong Leo Lee, MD
- Family Medicine Physician
- Brooklyn, NY
National Provider Identifier
1265496434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 1538741
- Practice address
- 195 Montague St
Annex Ctr
Brooklyn, NY 11201 - Phone
- (718) 826-4300
- Fax
- (718) 826-4415
- NPI assigned
- Apr 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1538741 | NY | Primary |
Addresses
Primary practice location
195 Montague St
Annex Ctr
Brooklyn, NY 11201
Mailing address
55 Water St FL 12
New York, NY 10041-0004
Phone (646) 680-2888
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1538741 | NY | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510099200000",
"number": "1265496434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 WATER ST FL 12",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100410004",
"telephone_number": "646-680-2888",
"fax_number": "516-542-5556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "195 MONTAGUE ST",
"address_2": "ANNEX CTR",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11201",
"telephone_number": "718-826-4300",
"fax_number": "718-826-4415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "FONG",
"middle_name": "LEO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-14",
"last_updated": "2017-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "1538741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.