Provider Demographics
NPI:1851654115
Name:ANDONIAN, LEAH R (DO)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:R
Last Name:ANDONIAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:R
Other - Last Name:CIACCIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 551420
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33355-1420
Mailing Address - Country:US
Mailing Address - Phone:800-243-3839
Mailing Address - Fax:855-851-4405
Practice Address - Street 1:736 IRVING AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1687
Practice Address - Country:US
Practice Address - Phone:315-470-7828
Practice Address - Fax:315-470-5811
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286557207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology