Healthcare Provider Details

I. General information

NPI: 1467579466
Provider Name (Legal Business Name): CHIU SHAN LEUNG R.N.,C.N.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 09/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 WASHINGTON ST
BOSTON MA
02111-1415
US

IV. Provider business mailing address

885 WASHINGTON ST
BOSTON MA
02111-1415
US

V. Phone/Fax

Practice location:
  • Phone: 617-521-6844
  • Fax: 617-482-2930
Mailing address:
  • Phone: 617-521-6844
  • Fax: 617-482-2930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number167421
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: