Provider Demographics
NPI:1114813946
Name:LEE, AARON CHANGGUN (RPH)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:CHANGGUN
Last Name:LEE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:CHANGGUN
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 LINCOLN ST APT 703
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-2411
Mailing Address - Country:US
Mailing Address - Phone:202-280-0174
Mailing Address - Fax:
Practice Address - Street 1:324 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-8306
Practice Address - Country:US
Practice Address - Phone:781-643-4112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH1001188183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist