Healthcare Provider Details
I. General information
NPI: 1417866773
Provider Name (Legal Business Name): YUNJIN LEE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 2ND AVE
LONG BRANCH NJ
07740-6395
US
IV. Provider business mailing address
300 2ND AVE
LONG BRANCH NJ
07740-6395
US
V. Phone/Fax
- Phone: 732-923-6307
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 28RI04517200 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: