Healthcare Provider Details

I. General information

NPI: 1477970630
Provider Name (Legal Business Name): CELINE LEUNG D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 03/06/2024
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

381 PARK ST STE 200
HACKENSACK NJ
07601-4350
US

IV. Provider business mailing address

381 PARK ST STE 200
HACKENSACK NJ
07601-4350
US

V. Phone/Fax

Practice location:
  • Phone: 201-546-8510
  • Fax:
Mailing address:
  • Phone: 201-546-8510
  • Fax: 201-957-7316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number25MB10839300
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: