Provider Demographics
NPI:1881187490
Name:LEUNG, KWAN T (PHARM D)
Entity Type:Individual
Prefix:
First Name:KWAN
Middle Name:T
Last Name:LEUNG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4072 MCNERY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-8149
Mailing Address - Country:US
Mailing Address - Phone:614-596-0013
Mailing Address - Fax:
Practice Address - Street 1:3015 E LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-3047
Practice Address - Country:US
Practice Address - Phone:614-236-8622
Practice Address - Fax:614-236-9355
Is Sole Proprietor?:No
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032337931835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist