Provider Demographics
NPI:1902059009
Name:LEONG, CHUO REN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHUO REN
Middle Name:
Last Name:LEONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6911 YELLOWSTONE BLVD
Mailing Address - Street 2:APT. A46
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3761
Mailing Address - Country:US
Mailing Address - Phone:718-704-4011
Mailing Address - Fax:
Practice Address - Street 1:6911 YELLOWSTONE BLVD
Practice Address - Street 2:APT. A46
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3761
Practice Address - Country:US
Practice Address - Phone:718-704-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program