Sue Jeong Lee

Primary specialty

PharmacistTaxonomy code 183500000X

License

045939 Issued in NY

Practice address

3764 90TH St
Jackson Heights, NY 11372-7830

Phone

(718) 779-2221

NPI assigned

Jan 11, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vida Care Pharmacy LLC

  • Community/Retail Pharmacy
  • Jackson Heights, NY
  • NPI 1770129579
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1023294816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3764 90TH ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727830",
            "telephone_number": "718-779-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3764 90TH ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727830",
            "telephone_number": "718-779-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUE",
        "middle_name": "JEONG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "045939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02259694",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chu-Lin Nelson Lee, PHARMACIST
• Elizabeth E Lee, PHARMD
• Eun Jung Lee, DDS
• Grace Lee, CAT
• Jennifer Lee, OD
• Tong Lee, O.D
• Lefferts Medical Practice, LLC
• Amanda Beth Leiman, M.A.
• Kimberly Marie Lemieux, GRADUATE STUDENT
• Judith Estelle Lenning

• Pharmacist in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.