Provider Demographics
NPI:1437670593
Name:LEE, SIEW PENG (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SIEW PENG
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 1:4430 W BANCROFT ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-3942
Mailing Address - Country:US
Mailing Address - Phone:419-699-7791
Mailing Address - Fax:
Practice Address - Street 1:2257 N HOLLAND SYLVANIA RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-2646
Practice Address - Country:US
Practice Address - Phone:419-578-6465
Practice Address - Fax:419-578-6470
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03328686183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist