MEDICARE: DR. MICHAEL W 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	054319	NY

General Provider Information

NPI Number	:	1861715955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL W LEE PHARMD

Provider Business Mailing Address
First Line	:	393 CHESTNUT CT
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-4944
Country	:	US
Telephone Number	:	734-904-1212
Fax Number	:

Provider Business Practice Location Address
First Line	:	1827 MAIN ST
Second Line	:
City	:	PEEKSKILL
State	:	NY
Zip	:	10566-2505
Country	:	US
Telephone Number	:	914-737-3728
Fax Number	:

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

Provider Enumeration Date	:	03/04/2010
Last Update Date	:	03/04/2010

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