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Provider Information for 1477877033

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MIYA ELIZABETH BERNSON-LEUNG MD

Gender: FEMALE

Individual NPI: 1477877033

Calendar   Last Updated:  2013-02-21
  Certification Date: 

Details

Name Value
NPI 1477877033
Enumeration Date 2010-03-24
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE
BOSTON, MA 02115-5724
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 300 LONGWOOD AVE
BOSTON, MA 02115-5724
United States

Phone: 617-355-6000 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 2084N0402X - Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology MA 244415
No 390200000X - Student in an Organized Health Care Education/Training Program