Provider Demographics
NPI:1093037665
Name:LEE, SEWHAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:SEWHAN
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:SEAN
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:R PH
Mailing Address - Street 1:5 N TRANSIT ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-3601
Mailing Address - Country:US
Mailing Address - Phone:716-433-0367
Mailing Address - Fax:716-433-2559
Practice Address - Street 1:5 N TRANSIT ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-3601
Practice Address - Country:US
Practice Address - Phone:716-433-0367
Practice Address - Fax:716-433-2559
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI050690-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist