Provider Demographics
NPI:1871571372
Name:LEUNG, CHING SUM (MD)
Entity type:Individual
Prefix:DR
First Name:CHING
Middle Name:SUM
Last Name:LEUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BOWERY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-6702
Mailing Address - Country:US
Mailing Address - Phone:212-431-4307
Mailing Address - Fax:212-431-4307
Practice Address - Street 1:19 BOWERY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-6702
Practice Address - Country:US
Practice Address - Phone:212-431-4307
Practice Address - Fax:212-431-4307
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118799208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00221898Medicaid
NYC12475Medicare UPIN
95750ZTVP1Medicare PIN
NY00221898Medicaid