Provider Demographics
NPI:1609568815
Name:LEIGH, SYUZANNA (PA-C)
Entity Type:Individual
Prefix:
First Name:SYUZANNA
Middle Name:
Last Name:LEIGH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SYUZANNA
Other - Middle Name:
Other - Last Name:CHICHAKYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:66 LAWNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14228-1603
Mailing Address - Country:US
Mailing Address - Phone:954-646-2397
Mailing Address - Fax:
Practice Address - Street 1:66 LAWNWOOD DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14228-1603
Practice Address - Country:US
Practice Address - Phone:954-646-2397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant