Fang, Leslie Shu-Tung

Fang, Leslie Shu-Tung is an sole proprietor health care provider with primary practice located at 151 Merrimac St 3Rd Fl, Boston MA 02114-4714. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Fang, Leslie Shu-Tung can be contacted via phone (617) 742-2054.

Contact Information

Primary practice address
151 Merrimac St 3Rd Fl Boston MA 02114-4714
Phone: (617) 742-2054
Fax: (617) 742-3157
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 39471 Massachusetts

Profile Details

NPI number 1558351734
LBN Legal business name Fang, Leslie Shu-Tung
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 27th, 2005
Last updated Apr 22nd, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558351734 NPPES
Massachusetts Other 706451 TUFTS HEALTH PLAN
Massachusetts Other M09530 TUFTS HEALTH PLAN
Massachusetts MEDICAID 110037240/A TUFTS HEALTH PLAN

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