MEDICARE: MR. JIMMY LEUNG LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	072237-1	NY

General Provider Information

NPI Number	:	1013008739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JIMMY LEUNG LCSW

Provider Business Mailing Address
First Line	:	77 BAY 34TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4201
Country	:	US
Telephone Number	:	917-279-3908
Fax Number	:

Provider Business Practice Location Address
First Line	:	583 5TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-3503
Country	:	US
Telephone Number	:	917-279-3908
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/21/2022

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