Healthcare Provider Details

I. General information

NPI: 1215454780
Provider Name (Legal Business Name): LISA YEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PENN PLZ
NEW YORK NY
10119-0002
US

IV. Provider business mailing address

2174 W 7TH ST
BROOKLYN NY
11223-3717
US

V. Phone/Fax

Practice location:
  • Phone: 212-268-3999
  • Fax:
Mailing address:
  • Phone: 347-556-1458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number063294
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: