Provider Demographics
NPI:1194980755
Name:LEUNG, STELLA HOI TING (RPAC)
Entity type:Individual
Prefix:
First Name:STELLA HOI TING
Middle Name:
Last Name:LEUNG
Suffix:
Gender:F
Credentials:RPAC
Other - Prefix:
Other - First Name:STELLA
Other - Middle Name:
Other - Last Name:LEUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPAC
Mailing Address - Street 1:5645 MAIN ST
Mailing Address - Street 2:NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5045
Mailing Address - Country:US
Mailing Address - Phone:718-670-1231
Mailing Address - Fax:
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-670-1231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007221363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
5429L1Medicare UPIN