MEDICARE: MR. SEAN LEECHONG LMT

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	225700000X	Massage Therapist	011824	NY

General Provider Information

NPI Number	:	1104065408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SEAN LEECHONG LMT

Provider Business Mailing Address
First Line	:	2959 NORTHERN BLVD APT 24F
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-3650
Country	:	US
Telephone Number	:	917-971-8125
Fax Number	:

Provider Business Practice Location Address
First Line	:	2959 NORTHERN BLVD
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-3635
Country	:	US
Telephone Number	:	917-971-8125
Fax Number	:

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

Provider Enumeration Date	:	02/10/2009
Last Update Date	:	04/17/2026

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