Provider Demographics
NPI:1568744100
Name:LEE, ALEXANDER (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:LEE
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 1:120 STOCKWELL DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:MA
Mailing Address - Zip Code:02322-1149
Mailing Address - Country:US
Mailing Address - Phone:508-232-4003
Mailing Address - Fax:508-232-4011
Practice Address - Street 1:120 STOCKWELL DR
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:MA
Practice Address - Zip Code:02322-1149
Practice Address - Country:US
Practice Address - Phone:508-232-4003
Practice Address - Fax:508-232-4011
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH20795183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist