MEDICARE: NICHOLAS LEE 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	PH240602	MA

General Provider Information

NPI Number	:	1366176786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS LEE PHARMD

Provider Business Mailing Address
First Line	:	80 WILSON WAY STE A
Second Line	:
City	:	WESTWOOD
State	:	MA
Zip	:	02090-1806
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 WILSON WAY STE A
Second Line	:
City	:	WESTWOOD
State	:	MA
Zip	:	02090-1806
Country	:	US
Telephone Number	:	781-352-6500
Fax Number	:

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

Provider Enumeration Date	:	07/12/2022
Last Update Date	:	07/12/2022

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Directions to “ NICHOLAS LEE PHARMD” Practice Location

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