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General NPI Number Information
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NPI Number | 1073397600
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Entity Type | Individual
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Provider Name | LEAH MALKIN PA
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Gender | Female
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Dates
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Enumeration Date | 08/23/2023
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 44201 DEQUINDRE RD
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City | TROY
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State | MI
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Zip | 48085-1117
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Country | US
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Telephone | 248-840-5073
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Fax |
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Provider Business Mailing Address
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Address Line | 25775 W 10 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48033-4856
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601012045
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License Number State | MI
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