Provider Demographics
NPI:1831390095
Name:AHOYA, LEAH EBOSO (MD)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:EBOSO
Last Name:AHOYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CONNECTICUT AVE
Mailing Address - Street 2:
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-8616
Mailing Address - Country:US
Mailing Address - Phone:036-540-6262
Mailing Address - Fax:
Practice Address - Street 1:130 CONNECTICUT AVE
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-8616
Practice Address - Country:US
Practice Address - Phone:203-654-0626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD431777207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019363040Medicaid
PA113276FLTMedicare PIN