Provider Demographics
NPI:1447237003
Name:LEONG, PATRICK (DO)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:LEONG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 FOLEY ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-1213
Mailing Address - Country:US
Mailing Address - Phone:857-282-0777
Mailing Address - Fax:
Practice Address - Street 1:440 FOLEY ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02145-1213
Practice Address - Country:US
Practice Address - Phone:857-282-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7813207Q00000X
MA151924207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30005217Medicaid
NHRE1570Medicare ID - Type Unspecified
NHA02893Medicare UPIN