Provider Demographics
NPI:1699875310
Name:LEE, YOUNG M (PHARMACIST)
Entity type:Individual
Prefix:MS
First Name:YOUNG
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 KELLERHAUSE DR
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-5440
Mailing Address - Country:US
Mailing Address - Phone:845-849-1392
Mailing Address - Fax:
Practice Address - Street 1:VAMC CASTLE POINT, ROUTE 9-D
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:CASTLE POINT
Practice Address - State:NY
Practice Address - Zip Code:12511-5000
Practice Address - Country:US
Practice Address - Phone:845-831-2000
Practice Address - Fax:845-838-7634
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY2525183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist