Provider Demographics
NPI:1053557934
Name:LEE, JEANE M (OD)
Entity type:Individual
Prefix:MRS
First Name:JEANE
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1445 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2400
Mailing Address - Country:US
Mailing Address - Phone:516-616-1771
Mailing Address - Fax:516-616-0473
Practice Address - Street 1:733 ELMONT RD
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4035
Practice Address - Country:US
Practice Address - Phone:516-341-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-26
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0057271152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist