Organization
LESLIE S T FANG, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE SHU TUNG FANG MD,PHD (OWNER)
(617) 742-2054
Entity
Organization
Contact information
Practice address
151 MERRIMAC ST, 3RD FLOOR, BOSTON, MA 02114-4714
(617) 742-2054
(617) 742-3157
Mailing address
151 MERRIMAC ST, 3RD FLOOR, BOSTON, MA 02114-4714
(617) 742-2054
(617) 742-3157
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39471
MA
207RN0300X
Nephrology Physician
39471
MA
Other
Enumeration date
12/30/2008
Last updated
12/30/2008
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