Provider Demographics
NPI:1952644924
Name:LEUNG, GRACE (TEACHER)
Entity Type:Individual
Prefix:MS
First Name:GRACE
Middle Name:
Last Name:LEUNG
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4237 249TH ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1624
Mailing Address - Country:US
Mailing Address - Phone:718-279-4956
Mailing Address - Fax:
Practice Address - Street 1:4237 249TH ST
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11363-1624
Practice Address - Country:US
Practice Address - Phone:718-279-4956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist