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General NPI Number Information
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NPI Number | 1962688945
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Entity Type | Individual
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Provider Name | MRS. MI SUN LEE
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Gender | Female
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Dates
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Enumeration Date | 01/21/2008
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Last Update Date | 01/21/2008
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Provider Practice Location Address
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Address Line | 130 DYCKMAN ST
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City | NEW YORK
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State | NY
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Zip | 10040-1001
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Country | US
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Telephone | 212-304-4743
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Fax | 212-304-4798
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Provider Business Mailing Address
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Address Line | 241 UNION ST UNIT 402
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City | HACKENSACK
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State | NJ
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Zip | 07601-4261
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Country | US
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Telephone | 860-478-0850
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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 | 050428
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License Number State | NY
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