Provider Demographics
NPI:1366787947
Name:LEE, HYUN AH (PHARMACIST)
Entity type:Individual
Prefix:DR
First Name:HYUN AH
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:DR
Other - First Name:HELENA
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:7102 SWANSONG WAY
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1270
Mailing Address - Country:US
Mailing Address - Phone:301-395-4823
Mailing Address - Fax:301-395-4823
Practice Address - Street 1:7102 SWANSONG WAY
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1270
Practice Address - Country:US
Practice Address - Phone:301-395-4823
Practice Address - Fax:301-395-4823
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-07
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH100000706183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist