Individual ProviderMin Jae LeeStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address622 West 168h St, New York, NY 10032(212) 305-6100PECOS EnrollmentBased on the most recent information from CMS, provider Min Jae Lee does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1174403059Provider TypeIndividualFull NameLee, Min JaeGenderMaleSole ProprietorNoEnumeration Date9/3/2025Last Updated9/3/2025Contact InformationPractice LocationPractice Address622 West 168h St, New York, NY 10032Phone(212) 305-6100FaxUnlisted FaxMailing LocationMailing Address622 West 168h St, New York, NY 10032PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer