Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 241621 | NY |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 24621 | NY |
NPI | 1598892945 |
---|---|
Provider Name | Ava Ricka Leegant |
First Address | Bronx, NY 10461-1900 |
Second Address | Bronx, NY 10457-1045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 26/01/2021 |