Provider Demographics
NPI:1851706782
Name:ABUGISISA, LEENAH (MD)
Entity type:Individual
Prefix:DR
First Name:LEENAH
Middle Name:
Last Name:ABUGISISA
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 1:1 AKRON GENERAL AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307-2432
Mailing Address - Country:US
Mailing Address - Phone:216-444-2568
Mailing Address - Fax:216-444-7625
Practice Address - Street 1:1 AKRON GENERAL AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2432
Practice Address - Country:US
Practice Address - Phone:216-444-2568
Practice Address - Fax:216-444-7625
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH351520532080N0001X
MO2017030010208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2017017542OtherMISSOURI BOARD OF HEALING ARTS
OH35152053OtherSTATE MEDICAL BOARD OF OHIO