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Individual

DR. JONATHAN LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD, RPH

Contact information

Practice address
210 VILLAGE CENTER DR, LUSBY, MD 20657-6531
(410) 394-3711
(410) 394-3799
Mailing address
6 RUSTIC AVE, MEDFORD, NY 11763-4421
(631) 747-6215

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202215284
VA
183500000X
Pharmacist
Primary
060761
NY
183500000X
Pharmacist
24660
MD

Other

Enumeration date
08/04/2015
Last updated
10/28/2019
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