Provider Demographics
NPI:1801819966
Name:AUNG, LEI LEI (MD)
Entity Type:Individual
Prefix:
First Name:LEI
Middle Name:LEI
Last Name:AUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 RIDGE RD.
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852
Mailing Address - Country:US
Mailing Address - Phone:732-329-8215
Mailing Address - Fax:732-329-0036
Practice Address - Street 1:613 RIDGE RD.
Practice Address - Street 2:SUITE 104
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852
Practice Address - Country:US
Practice Address - Phone:732-329-8215
Practice Address - Fax:732-329-0036
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA61217207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6404103Medicaid
NJF97209Medicare UPIN
NJ6404103Medicaid