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General NPI Number Information
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NPI Number | 1831611490
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Entity Type | Individual
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Provider Name | EUN A LEE
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Gender | Female
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Dates
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Enumeration Date | 07/14/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 3632 UNION ST STE A
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City | FLUSHING
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State | NY
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Zip | 11354-4195
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Country | US
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Telephone | 718-961-6010
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Fax |
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Provider Business Mailing Address
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Address Line | 607 MONTVIEW PL
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City | RIVER VALE
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State | NJ
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Zip | 07675-6223
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Country | US
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Telephone | 917-744-9999
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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 | 28RI03742400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 061026
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License Number State | NY
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