Provider Demographics
NPI:1174807960
Name:LEUNG, STEPHANIE L (BS IN PHARMACY)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:L
Last Name:LEUNG
Suffix:
Gender:F
Credentials:BS IN PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 DUNCAN RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-3809
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 TOLER PL
Practice Address - Street 2:TERMINAL C
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07114-1431
Practice Address - Country:US
Practice Address - Phone:973-273-9510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02598300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist