Healthcare Provider Details

I. General information

NPI: 1487092490
Provider Name (Legal Business Name): LEAH ASHLEY BONAPARTE-DOTTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2013
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N 17TH ST
ALLENTOWN PA
18104-5052
US

IV. Provider business mailing address

400 N 17TH ST
ALLENTOWN PA
18104-5052
US

V. Phone/Fax

Practice location:
  • Phone: 910-484-2284
  • Fax: 910-484-1673
Mailing address:
  • Phone: 910-484-2284
  • Fax: 910-484-1673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35884
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLL35884
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2018-00520
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD477484
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: