Provider Demographics
NPI:1033194352
Name:LEUNG, KEENA YUE (MD)
Entity Type:Individual
Prefix:DR
First Name:KEENA
Middle Name:YUE
Last Name:LEUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3307 HARBOR LN N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447
Mailing Address - Country:US
Mailing Address - Phone:952-993-8900
Mailing Address - Fax:952-993-8909
Practice Address - Street 1:3007 HARBOR LN N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-5103
Practice Address - Country:US
Practice Address - Phone:952-993-8900
Practice Address - Fax:952-993-8909
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN40304208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN253727300Medicaid
MN370001487Medicare Oscar/Certification
MN253727300Medicaid
MNG55221Medicare UPIN