Provider Demographics
NPI:1336506567
Name:LENG, BORA (N/A)
Entity Type:Individual
Prefix:
First Name:BORA
Middle Name:
Last Name:LENG
Suffix:
Gender:M
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4206 THOMAS AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55412-1520
Mailing Address - Country:US
Mailing Address - Phone:612-721-5878
Mailing Address - Fax:612-721-5778
Practice Address - Street 1:4206 THOMAS AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55412-1520
Practice Address - Country:US
Practice Address - Phone:612-721-5878
Practice Address - Fax:612-721-5778
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter