Provider Demographics
NPI:1215263413
Name:LEE, ALBERT KWANG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:KWANG
Last Name:LEE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63A MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:ASHBURNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01430
Mailing Address - Country:US
Mailing Address - Phone:978-827-4190
Mailing Address - Fax:978-827-4192
Practice Address - Street 1:63A MAIN ST.
Practice Address - Street 2:
Practice Address - City:ASHBURNHAM
Practice Address - State:MA
Practice Address - Zip Code:01430
Practice Address - Country:US
Practice Address - Phone:978-827-4190
Practice Address - Fax:978-827-4192
Is Sole Proprietor?:No
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH232367183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist