Provider Demographics
NPI:1245578004
Name:LEE, ALICE (PHARM D)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3085 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-5720
Mailing Address - Country:US
Mailing Address - Phone:718-863-2677
Mailing Address - Fax:718-863-0442
Practice Address - Street 1:3085 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5720
Practice Address - Country:US
Practice Address - Phone:718-863-2677
Practice Address - Fax:718-863-0442
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057687183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist