Provider Demographics
NPI:1013655679
Name:LEUNG, KIT FUNG (RDN)
Entity Type:Individual
Prefix:MR
First Name:KIT FUNG
Middle Name:
Last Name:LEUNG
Suffix:
Gender:M
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 SPRUCE LN
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-1449
Mailing Address - Country:US
Mailing Address - Phone:704-490-8116
Mailing Address - Fax:
Practice Address - Street 1:102 LEONARD AVE
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-9649
Practice Address - Country:US
Practice Address - Phone:828-465-8591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004327133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered