Provider Demographics
NPI:1194199265
Name:BOCCHICCHIO, LEAH ANN (APN-BC)
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:ANN
Last Name:BOCCHICCHIO
Suffix:
Gender:F
Credentials:APN-BC
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:RICCIARDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 JACOBS LN
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4125
Mailing Address - Country:US
Mailing Address - Phone:609-560-3423
Mailing Address - Fax:
Practice Address - Street 1:2500 ENGLISH CREEK AVE
Practice Address - Street 2:BLD. 200. SUITE 214
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-5549
Practice Address - Country:US
Practice Address - Phone:609-909-0200
Practice Address - Fax:609-909-0267
Is Sole Proprietor?:No
Enumeration Date:2015-11-30
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00604900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily