Basic Information
Provider Information
NPI: 1669672093
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEONG
FirstName: NOELLE
MiddleName: MARIE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: 2110 SILAS DEANE HWY
Address2: STARLING PHYSICIANS
City: ROCKY HILL
State: CT
PostalCode: 060672313
CountryCode: US
TelephoneNumber: 8602583470
FaxNumber: 8605716800
Practice Location
Address1: 300 KENSINGTON AVE
Address2: STARLING PEDIATRICS
City: NEW BRITAIN
State: CT
PostalCode: 060513916
CountryCode: US
TelephoneNumber: 8602246282
FaxNumber: 8608264959
Other Information
ProviderEnumerationDate: 07/24/2007
LastUpdateDate: 01/25/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X046040CTY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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