Active NPI
Justin David Lee
- Pharmacist
- Oakland Gardens, NY
National Provider Identifier
1073395364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 070987
- Practice address
- 22310 Union Tpke
Oakland Gardens, NY 11364-3645 - Phone
- (718) 762-7111
- NPI assigned
- Oct 20, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 070987 | NY | Primary |
Addresses
Primary practice location
22310 Union Tpke
Oakland Gardens, NY 11364-3645
Mailing address
22310 Union Tpke
Oakland Gardens, NY 11364-3645
Phone (718) 762-7111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070987 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713744000000",
"number": "1073395364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22310 UNION TPKE",
"city": "OAKLAND GARDENS",
"state": "NY",
"postal_code": "113643645",
"telephone_number": "718-762-7111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22310 UNION TPKE",
"city": "OAKLAND GARDENS",
"state": "NY",
"postal_code": "113643645",
"telephone_number": "718-762-7111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JUSTIN",
"middle_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-10-20",
"last_updated": "2024-04-22",
"certification_date": "2024-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "070987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland Gardens, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.