Individual ProviderKevin Y LeePharmacistPharmacy Service ProvidersPractice Address617 W 181st St, New York, NY 10033-4937(212) 923-6912(917) 648-1242PECOS EnrollmentBased on the most recent information from CMS, provider Kevin Y Lee does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 11 days ago.Profile DetailsProvider ID1750538542Provider TypeIndividualFull NameLee, Kevin YTitleMr.GenderMaleSole ProprietorYesEnumeration Date8/22/2008Last Updated7/21/2022Contact InformationPractice LocationPractice Address617 W 181st St, New York, NY 10033-4937Phone(212) 923-6912Fax(212) 923-6934Mailing LocationMailing Address208 Madison Ave, River Edge, NJ 07661-1310Phone(917) 648-1242FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicense046379New YorkProvider IdentifiersIDDescriptionIssuerID046379DescriptionOtherIssuerNY STATE PHARMACIST LICENSE NUMBERSNew York