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NPI Code Detail

MEDICARE: DR. SALLY LEE PHARM.D

MEDICARE: DR. SALLY LEE PHARM.D
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
1183500000XPharmacist051237NY

General Provider Information

NPI Number : 1376074088
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SALLY LEE PHARM.D
Provider Business Mailing Address
First Line : 8631 20TH AVE
Second Line : APARTMENT 2
City : BROOKLYN
State : NY
Zip : 11214-3921
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3921 9TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-3207
Country : US
Telephone Number : 718-435-7790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2017
Last Update Date : 03/23/2017

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