MEDICARE: MR. LEE JOSEPH GRABE PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	049424	NY

General Provider Information

NPI Number	:	1144404518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LEE JOSEPH GRABE PHARMD

Provider Business Mailing Address
First Line	:	6 AUGUSTA DR
Second Line	:
City	:	CORTLANDT MANOR
State	:	NY
Zip	:	10567-3111
Country	:	US
Telephone Number	:	845-926-7388
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 ROUTE 52
Second Line	:
City	:	CARMEL
State	:	NY
Zip	:	10512-1200
Country	:	US
Telephone Number	:	845-225-4134
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2007
Last Update Date	:	12/20/2007

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