Provider Demographics
NPI:1598701971
Name:LEONG, MILA A (MD)
Entity Type:Individual
Prefix:DR
First Name:MILA
Middle Name:A
Last Name:LEONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1750 ZION RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1844
Mailing Address - Country:US
Mailing Address - Phone:609-677-4566
Mailing Address - Fax:609-677-6080
Practice Address - Street 1:1750 ZION RD
Practice Address - Street 2:SUITE 107
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1844
Practice Address - Country:US
Practice Address - Phone:609-677-4566
Practice Address - Fax:609-677-6080
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB059693002080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1203597003OtherCIGNA
NJ5591219OtherAETNA PPO
NJ722082OtherAMERIHEALTH ADMINISTRATOR
NJ01000713800OtherAMERICHOICE
NJ2K4836OtherHEALTH NET
NJ39150OtherUNIVERSITY HEALTH PLANS
NJ6854109Medicaid
NJ22415OtherAMERIGROUP
NJP3418596OtherOXFORD HEALTH PLANS
NJ5271880OtherFIRST HEALTH
NJ0266373000OtherAMERIHEALTH
NJ3694556OtherAETNA HMO
NJ60009926OtherHORIZON NEW JERSEY HEALTH
NJ6854109Medicaid