Provider Demographics
NPI:1225806813
Name:LEE, DO RIM (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:DO RIM
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4210 27TH ST APT 11F
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4179
Mailing Address - Country:US
Mailing Address - Phone:909-664-4344
Mailing Address - Fax:
Practice Address - Street 1:2495 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7427
Practice Address - Country:US
Practice Address - Phone:212-787-2194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy