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NPI Code Detail

MEDICARE: DR. JACQUELINE LEE PHARMD

MEDICARE: DR. JACQUELINE 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
1183500000XPharmacistPCT.0010554CT

General Provider Information

NPI Number : 1962864546
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACQUELINE LEE PHARMD
Provider Business Mailing Address
First Line : 1057 BOSTON POST RD
Second Line :
City : GUILFORD
State : CT
Zip : 06437-2644
Country : US
Telephone Number : 203-458-1444
Fax Number : 203-458-2182
Provider Business Practice Location Address
First Line : 1057 BOSTON POST RD
Second Line :
City : GUILFORD
State : CT
Zip : 06437-2644
Country : US
Telephone Number : 203-458-1444
Fax Number : 203-458-2182
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2016
Last Update Date : 03/23/2016

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