Healthcare Provider Details

I. General information

NPI: 1811335748
Provider Name (Legal Business Name): PATRICK LEUNG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2013
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 STEWART AVE STE 100
GARDEN CITY NY
11530-4833
US

IV. Provider business mailing address

1101 STEWART AVE STE 100
GARDEN CITY NY
11530-4833
US

V. Phone/Fax

Practice location:
  • Phone: 516-536-2800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number125-063179
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number313782
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: