Provider Demographics
NPI:1457973877
Name:LEISER, AYALA (PA)
Entity Type:Individual
Prefix:
First Name:AYALA
Middle Name:
Last Name:LEISER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:AYALA
Other - Middle Name:
Other - Last Name:SILVERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:780 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-1706
Mailing Address - Country:US
Mailing Address - Phone:201-218-8462
Mailing Address - Fax:
Practice Address - Street 1:780 CEDAR LN
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-1706
Practice Address - Country:US
Practice Address - Phone:201-836-7664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-07
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant