Provider Demographics
NPI:1134421191
Name:LEE, CHRISTINA (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:CHRISTINA
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 1:1 SOUTH DAVENPORT STREET
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876
Mailing Address - Country:US
Mailing Address - Phone:908-231-7400
Mailing Address - Fax:908-231-7428
Practice Address - Street 1:1 SOUTH DAVENPORT STREET
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876
Practice Address - Country:US
Practice Address - Phone:908-231-7400
Practice Address - Fax:908-231-7428
Is Sole Proprietor?:No
Enumeration Date:2010-11-24
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03080400183500000X
PARP445359183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist