Provider Demographics
NPI:1326225251
Name:LEUNG, JACQUELYN W (MD)
Entity Type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:W
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 1:1000 MORRIS AVE
Mailing Address - Street 2:STUDENT HEALTH DOWNS HALL #126 KEAN UNIVERSITY
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083
Mailing Address - Country:US
Mailing Address - Phone:908-737-5326
Mailing Address - Fax:
Practice Address - Street 1:1000 MORRIS AVE
Practice Address - Street 2:STUDENT HEALTH DOWNS HALL #126 KEAN UNIVERSITY
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083
Practice Address - Country:US
Practice Address - Phone:908-737-5326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08249200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine