Provider Demographics
NPI:1871830430
Name:NICKY LEUNG, MD
Entity Type:Organization
Organization Name:NICKY LEUNG, MD
Other - Org Name:NEWTON-WELLESLEY ORTHOPEDIC ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NICKY
Authorized Official - Middle Name:LEE-GI
Authorized Official - Last Name:LEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-769-0125
Mailing Address - Street 1:825 WASHINGTON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3441
Mailing Address - Country:US
Mailing Address - Phone:781-769-0125
Mailing Address - Fax:781-769-0352
Practice Address - Street 1:825 WASHINGTON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3441
Practice Address - Country:US
Practice Address - Phone:781-769-0125
Practice Address - Fax:781-769-0352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA243021207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
M12224Medicare UPIN