Individual
JACKIE LEONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1419 35TH ST, BROOKLYN, NY 11218-3727
(914) 747-2438
Mailing address
1419 35TH ST, BROOKLYN, NY 11218-3727
(914) 747-2438
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
25MA05941500
NJ
2085N0904X
Nuclear Radiology Physician
25MA05941500
NJ
2085R0202X
Diagnostic Radiology Physician
25MA05941500
NJ
2085U0001X
Diagnostic Ultrasound Physician
Primary
25MA05941500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0058289
—
NJ
Enumeration date
09/01/2006
Last updated
09/11/2025
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