Active NPI
Jeong Ran Oh Lee, MD
- Pediatrics Physician
- Brooklyn, NY
National Provider Identifier
1366596132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 196624
- Practice address
- 14 Heyward St
Brooklyn, NY 11249-7823 - Phone
- (718) 260-4600
- Fax
- (718) 852-0867
- NPI assigned
- Jan 22, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 196624 | NY | Primary |
Addresses
Primary practice location
14 Heyward St
Brooklyn, NY 11249-7823
Mailing address
14 Heyward St
Brooklyn, NY 11249-7823
Phone (718) 260-4600
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 196624 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326153600000",
"number": "1366596132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 HEYWARD ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112497823",
"telephone_number": "718-260-4600",
"fax_number": "718-852-0867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 HEYWARD ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112497823",
"telephone_number": "718-260-4600",
"fax_number": "718-852-0867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JEONG",
"middle_name": "RAN OH",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2012-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "196624",
"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 Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.