Provider Demographics
NPI:1871897561
Name:LEE, CYNTHIA DENISE
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DENISE
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 S BROADWAY
Mailing Address - Street 2:PHARMACY
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-4006
Mailing Address - Country:US
Mailing Address - Phone:914-378-7664
Mailing Address - Fax:914-378-7209
Practice Address - Street 1:127 S BROADWAY
Practice Address - Street 2:PHARMACY
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-4006
Practice Address - Country:US
Practice Address - Phone:914-378-7664
Practice Address - Fax:914-378-7209
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician