Basic Information
Provider Information
NPI: 1508183252
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEUNG
FirstName: HELEN
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: R.PH.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 211 E 79TH ST
Address2: 2ND FLOOR PHARMACY
City: NEW YORK
State: NY
PostalCode: 100750819
CountryCode: US
TelephoneNumber: 2128791600
FaxNumber: 2128794594
Practice Location
Address1: 211 E 79TH ST
Address2: 2ND FLOOR PHARMACY
City: NEW YORK
State: NY
PostalCode: 100750819
CountryCode: US
TelephoneNumber: 2128791600
FaxNumber: 2128794594
Other Information
ProviderEnumerationDate: 04/21/2010
LastUpdateDate: 04/21/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X037961NYY Pharmacy Service ProvidersPharmacist 

No ID Information.


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