MEDICARE: DR. JOHN LEUNG M.D.

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	207KI0005X	Clinical & Laboratory Immunology (Allergy & Immunology) Physician	230907	MA
2	207K00000X	Allergy & Immunology Physician	230907	MA
3	207R00000X	Internal Medicine Physician	230907	MA
4	207RG0100X	Gastroenterology Physician	230907	MA

General Provider Information

NPI Number	:	1447328711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN LEUNG M.D.

Provider Business Mailing Address
First Line	:	1 NASSAU ST UNIT 1906
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02111-1587
Country	:	US
Telephone Number	:	617-804-6767
Fax Number	:	877-726-8492

Provider Business Practice Location Address
First Line	:	65 HARRISON AVE STE 201
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02111-1924
Country	:	US
Telephone Number	:	617-804-6767
Fax Number	:	877-726-8492

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

Provider Enumeration Date	:	12/02/2006
Last Update Date	:	07/28/2022

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