1033696828 NPI number — DR. SHUK ON ANNIE LEUNG MD

Table of content: DR. SHUK ON ANNIE LEUNG MD (NPI 1033696828)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033696828 NPI number — DR. SHUK ON ANNIE LEUNG MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEUNG
Provider First Name:
SHUK ON
Provider Middle Name:
ANNIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033696828
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/24/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
75 FRANCIS STREET
Provider Second Line Business Mailing Address:
GYNECOLOGIC ONCOLOGY ASB1, 3RD FLOOR ROOM 3173
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02115-6106
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-732-8843
Provider Business Mailing Address Fax Number:
617-738-5124

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 FRANCIS STREET
Provider Second Line Business Practice Location Address:
GYNECOLOGIC ONCOLOGY ASB1, 3RD FLOOR ROOM 3173
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02115-6106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-732-8843
Provider Business Practice Location Address Fax Number:
617-738-5124
Provider Enumeration Date:
07/24/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)