Active NPI
David Jared Lee, R.PH.
- Pharmacist
- Glen Cove, NY
National Provider Identifier
1083938211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 045297
- Practice address
- 93 Forest Ave
Glen Cove, NY 11542-2109 - Phone
- (516) 671-4908
- NPI assigned
- Mar 17, 2010
- 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 | 045297 | NY | Primary |
Addresses
Primary practice location
93 Forest Ave
Glen Cove, NY 11542-2109
Mailing address
93 Forest Ave
Glen Cove, NY 11542-2109
Phone (516) 671-4908
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045297 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268784000000",
"number": "1083938211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "93 FOREST AVE",
"city": "GLEN COVE",
"state": "NY",
"postal_code": "115422109",
"telephone_number": "516-671-4908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "93 FOREST AVE",
"city": "GLEN COVE",
"state": "NY",
"postal_code": "115422109",
"telephone_number": "516-671-4908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "DAVID",
"middle_name": "JARED",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-17",
"last_updated": "2010-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "045297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Cove, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.