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EDWIN JIN SU LEE M.D. NPI 1972921047


NPI Information

NPI: 1972921047
Provider Name: EDWIN JIN SU LEE, M.D.
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual
Organization: GASTROINTESTINAL AND LIVER SPECIALISTS OF TIDEWATER PLLC

PECOS Registration: Yes

Address:
601 ELMWOOD AVE
ROCHESTER, NY
ZIP 14642
Phone: (585) 275-8113
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Edwin Jin Su Lee, M.D. is a student in an organized health care education training program in Rochester, NY with 13 years of experience. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Edwin Jin Su Lee, M.D. NPI is 1972921047. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

601 ELMWOOD AVE
ROCHESTER, NY
ZIP 14642
Phone: (585) 275-8113

The NPI 1972921047 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/4/2014 and was last updated on 11/1/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
2390200000XStudent in an Organized Health Care Education/Training ProgramNEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.