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NPI Code Detail

MEDICARE: SAMUEL LEE PHARM. D.

MEDICARE: SAMUEL 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
1183500000XPharmacist28RI03641300NJ

General Provider Information

NPI Number : 1942619218
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL LEE PHARM. D.
Provider Business Mailing Address
First Line : 1568 ASTON TER
Second Line :
City : FORT LEE
State : NJ
Zip : 07024-4601
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2160 LEMOINE AVE
Second Line :
City : FORT LEE
State : NJ
Zip : 07024-6002
Country : US
Telephone Number : 201-346-0002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2014
Last Update Date : 08/11/2014

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Directions to “ SAMUEL LEE PHARM. D.” Practice Location

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