Provider Demographics
NPI:1063703429
Name:LEUNG, ERIC
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:LEUNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5645 MAIN ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5045
Mailing Address - Country:US
Mailing Address - Phone:516-321-6400
Mailing Address - Fax:
Practice Address - Street 1:1554 NORTHERN BLVD
Practice Address - Street 2:4TH FLOOR
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3006
Practice Address - Country:US
Practice Address - Phone:516-321-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA135316208100000X
NY267257208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine