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General NPI Number Information
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NPI Number | 1386130490
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Entity Type | Individual
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Provider Name | GINA LEE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/02/2018
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 30 WINTER ST
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City | BOSTON
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State | MA
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Zip | 02108-4720
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Country | US
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Telephone | 857-274-4542
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Fax |
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Provider Business Mailing Address
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Address Line | 34 LAUREL ST # 2
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City | SOMERVILLE
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State | MA
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Zip | 02143-2731
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH238314
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License Number State | MA
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