Eugene S. Lee DC, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00636500 Issued in NJ

Legal business name

EUGENE S. LEE DC, LLC

Doing business as

Edgewater Chiropractic & Acupuncture

Practice address

725 River Rd
Suite 102
Edgewater, NJ 07020-1171

Phone

(201) 943-7768

Fax

(201) 943-7798

NPI assigned

Sep 1, 2007

Last updated

Sep 1, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Eugene Seungkyu Lee, DC, LACNPI 1326241910

Title

Chiropractor

Phone

(201) 943-7768

Specialties & licenses 1

Addresses

Other names 1

• Edgewater Chiropractic & Acupuncture Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eugene Seungkyu Lee, D.C.

  • Acupuncturist
  • Edgewater, NJ
  • NPI 1326241910

  Chiropractor

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1188604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188604800000",
    "number": "1285828277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 RIVER RD",
            "address_2": "SUITE 102",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201171",
            "telephone_number": "201-943-7768",
            "fax_number": "201-943-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 RIVER RD",
            "address_2": "SUITE 102",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201171",
            "telephone_number": "201-943-7768",
            "fax_number": "201-943-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENE S. LEE DC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-01",
        "last_updated": "2007-09-01",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "SEUNGKYU",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "201-943-7768",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, LAC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00636500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgewater Chiropractic & Acupuncture",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Edgewater, NJ
• Providers in Edgewater, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.