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General NPI Number Information
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NPI Number | 1750538542
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Entity Type | Individual
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Provider Name | MR. KEVIN Y LEE
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Gender | Male
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Dates
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Enumeration Date | 08/22/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 617 W 181ST ST
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City | NEW YORK
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State | NY
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Zip | 10033-4937
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Country | US
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Telephone | 212-923-6912
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Fax | 212-923-6934
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Provider Business Mailing Address
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Address Line | 208 MADISON AVE
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City | RIVER EDGE
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State | NJ
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Zip | 07661-1310
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Country | US
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Telephone | 917-648-1242
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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 | 046379
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License Number State | NY
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