Provider Demographics
NPI:1972780674
Name:LEE, LANDE Y (PHARMD)
Entity type:Individual
Prefix:MISS
First Name:LANDE
Middle Name:Y
Last Name:LEE
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 1:1500 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-7349
Mailing Address - Country:US
Mailing Address - Phone:212-289-3846
Mailing Address - Fax:212-289-3550
Practice Address - Street 1:1500 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7349
Practice Address - Country:US
Practice Address - Phone:212-289-3846
Practice Address - Fax:212-289-3550
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050531183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist