Individual ProviderByoung Im LeeNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address636 Brooklyn Ave Apt 5j, Brooklyn, NY 11203-1616(347) 366-4295PECOS EnrollmentBased on the most recent information from CMS, provider Byoung Im 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 ID1720604663Provider TypeIndividualFull NameLee, Byoung ImCredentialNPGenderFemaleSole ProprietorNoEnumeration Date6/16/2020Last Updated6/16/2020Contact InformationPractice LocationPractice Address636 Brooklyn Ave Apt 5j, Brooklyn, NY 11203-1616Phone(347) 366-4295FaxUnlisted FaxMailing LocationMailing Address636 Brooklyn Ave Apt 5j, Brooklyn, NY 11203-1616Phone(347) 366-4295FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense342393New York