Provider Demographics
NPI:1952350340
Name:AUTY, CLARA LEER-LUN (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARA
Middle Name:LEER-LUN
Last Name:AUTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CLARA
Other - Middle Name:LEER-LUN
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:369 VALLEY BROOK DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-8782
Mailing Address - Country:US
Mailing Address - Phone:859-402-2159
Mailing Address - Fax:
Practice Address - Street 1:650 NEWTOWN PIKE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-1113
Practice Address - Country:US
Practice Address - Phone:859-252-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222017207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
7746384OtherAETNA
NY02174550Medicaid
7700234OtherUNITED HEALTH CARE
NY000923270001OtherHEALTHY NEW YORK
1070004BFOtherPREFERRED CARE
7700234OtherUNITED HEALTH CARE
NYCC7869Medicare ID - Type UnspecifiedMEDICARE NUMBER