MEDICARE: RICHARD LEONG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	I059513	NY

General Provider Information

NPI Number	:	1467852715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD LEONG

Provider Business Mailing Address
First Line	:	711 DUNNE CT
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-6122
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3250 VERNON BLVD
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11106-4927
Country	:	US
Telephone Number	:	718-267-5516
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2014
Last Update Date	:	05/04/2023

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Directions to “ RICHARD LEONG ” Practice Location

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