Provider Demographics
NPI:1033269873
Name:LEI, TJEN-HAI (RPH)
Entity Type:Individual
Prefix:MR
First Name:TJEN-HAI
Middle Name:
Last Name:LEI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 WEST END AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010
Mailing Address - Country:US
Mailing Address - Phone:718-579-5864
Mailing Address - Fax:718-579-5003
Practice Address - Street 1:234 E 149TH ST RM C-23B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5504
Practice Address - Country:US
Practice Address - Phone:718-579-5864
Practice Address - Fax:718-579-5003
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039149183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist