Provider Demographics
NPI:1497143069
Name:LEUNG, SERENA
Entity Type:Individual
Prefix:
First Name:SERENA
Middle Name:
Last Name:LEUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 PENNSYLVANIA AVE APT 5G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11239-1203
Mailing Address - Country:US
Mailing Address - Phone:917-371-6915
Mailing Address - Fax:
Practice Address - Street 1:1155 PENNSYLVANIA AVE
Practice Address - Street 2:AOT. 5G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11239-1215
Practice Address - Country:US
Practice Address - Phone:917-371-6915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY693320163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse