MEDICARE: MS. SHIRLEY LEUNG RPH

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	047709	NY

General Provider Information

NPI Number	:	1528190543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHIRLEY LEUNG RPH

Provider Business Mailing Address
First Line	:	1512 WESTGATE DR
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-2172
Country	:	US
Telephone Number	:	646-289-2990
Fax Number	:

Provider Business Practice Location Address
First Line	:	5564 BROADWAY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-5216
Country	:	US
Telephone Number	:	718-548-5884
Fax Number	:

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

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/08/2007

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