Provider Demographics
NPI:1104282078
Name:LE, JENNIFER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 EXTERIOR ST STE 501A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-2055
Mailing Address - Country:US
Mailing Address - Phone:718-401-5652
Mailing Address - Fax:
Practice Address - Street 1:700 EXTERIOR ST STE 501A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-2055
Practice Address - Country:US
Practice Address - Phone:718-401-5652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061142183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist