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General NPI Number Information
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NPI Number | 1639802036
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Entity Type | Individual
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Provider Name | MARCUS LEUNG OD
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Gender | Male
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Dates
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Enumeration Date | 07/05/2022
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 30 KINGSLAND RD
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City | CLIFTON
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State | NJ
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Zip | 07014-1904
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Country | US
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Telephone | 917-750-2065
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Fax |
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Provider Business Mailing Address
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Address Line | 276 BROAD AVE APT 8
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City | PALISADES PARK
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State | NJ
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Zip | 07650-1593
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Country | US
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Telephone | 917-750-2065
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00713800
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License Number State | NJ
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