Provider Demographics
NPI:1982608444
Name:LEUNG, MELISSA (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:LEUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 LAFAYETTE ST
Mailing Address - Street 2:FL 4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4138
Mailing Address - Country:US
Mailing Address - Phone:212-274-1900
Mailing Address - Fax:212-274-0738
Practice Address - Street 1:109 LAFAYETTE ST
Practice Address - Street 2:FL 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4138
Practice Address - Country:US
Practice Address - Phone:212-274-1900
Practice Address - Fax:212-274-0738
Is Sole Proprietor?:No
Enumeration Date:2005-06-11
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208783-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02198621Medicaid
NY384A0X0691Medicare PIN
NYH17023Medicare UPIN