Provider Demographics
NPI:1336366574
Name:KOVAL, LEAH D (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:D
Last Name:KOVAL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 AIDAN CT
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226-2472
Mailing Address - Country:US
Mailing Address - Phone:412-302-8901
Mailing Address - Fax:
Practice Address - Street 1:320 E NORTH AVE STE 401
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-4352
Practice Address - Fax:412-359-8285
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052672363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103185064Medicaid
11758821OtherCAQH