Provider Demographics
NPI:1770815516
Name:LEUNG, JUNGYEON (DC)
Entity Type:Individual
Prefix:DR
First Name:JUNGYEON
Middle Name:
Last Name:LEUNG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4161 KISSENA BLVD
Mailing Address - Street 2:STE 22
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3131
Mailing Address - Country:US
Mailing Address - Phone:718-359-0330
Mailing Address - Fax:
Practice Address - Street 1:4161 KISSENA BLVD
Practice Address - Street 2:SUITE 22, CONCOURSE LEVEL
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3181
Practice Address - Country:US
Practice Address - Phone:516-312-0901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00688700111N00000X
390200000X
NY012089111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program