Individual provider Active NPI

Eunyoung Lee, RN

  • Registered Nurse
  • Freeport, NY
National Provider Identifier
1366148926
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
840120 Issued in NY
Practice address
72 Guy Lombardo Ave
Freeport, NY 11520-3742
Phone
(516) 226-3615
Fax
(516) 223-5000
NPI assigned
Feb 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 840120 NY Primary

Addresses

Primary practice location

72 Guy Lombardo Ave
Freeport, NY 11520-3742

Mailing address

185 8TH St
Bethpage, NY 11714-1801
Phone (516) 306-7344

Other identifiers 1

IdentifierTypeStateIssuer
457711018OtherNYNYS DRIVER LICENSE

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
840120NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1366148926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 8TH ST",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117141801",
            "telephone_number": "516-306-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 GUY LOMBARDO AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203742",
            "telephone_number": "516-226-3615",
            "fax_number": "516-223-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "EUNYOUNG",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "840120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS DRIVER LICENSE",
            "identifier": "457711018",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.