Provider Demographics
NPI:1962640094
Name:LEE, LILLIAN CECILIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:CECILIA
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:LILLIAN
Other - Middle Name:CECILIA
Other - Last Name:CHUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1968 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-2813
Mailing Address - Country:US
Mailing Address - Phone:516-379-2182
Mailing Address - Fax:
Practice Address - Street 1:1968 GRAND AVE
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-2813
Practice Address - Country:US
Practice Address - Phone:516-379-2182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052041183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist