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General NPI Number Information
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NPI Number | 1689320509
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Entity Type | Individual
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Provider Name | WING FUN LEO-TO
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Gender | Female
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Dates
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Enumeration Date | 03/01/2022
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 5645 MAIN ST
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City | FLUSHING
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State | NY
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Zip | 11355-5045
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Country | US
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Telephone | 718-670-2763
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Fax | 718-670-1316
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Provider Business Mailing Address
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Address Line | 5645 MAIN ST
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City | FLUSHING
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State | NY
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Zip | 11355-5045
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Country | US
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Telephone | 718-670-2763
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Fax | 718-670-1316
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 046176
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License Number State | NY
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