MEDICARE: PONYA DIAGNOSTICS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1629964721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PONYA DIAGNOSTICS, LLC

Provider Business Mailing Address
First Line	:	13 CORPORATE BLVD NE STE 250
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30329-1901
Country	:	US
Telephone Number	:	229-442-7210
Fax Number	:	404-759-2019

Provider Business Practice Location Address
First Line	:	13 CORPORATE BLVD NE STE 100
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30329-1905
Country	:	US
Telephone Number	:	229-442-7210
Fax Number	:	404-759-2019

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MEKONNEN ABEBE
Credential	:
Telephone Number	:	229-442-7210

Provider Enumeration Date	:	06/16/2025
Last Update Date	:	12/09/2025

Similar Medicare Providers

1508903048 — DR. SWATI M KANDALKAR DMD
Practice Location Address:

13 CORPORATE BLVD NE STE 120
BROOKHAVEN, GA
30329-1905

Practice Phone: 678-836-2120
Practice Fax: 404-320-9552

1922579192 — UNITED PHYSICIAN GROUP LLC
Practice Location Address:

13 CORPORATE BLVD NE STE 100
BROOKHAVEN, GA
30329-1905

Practice Phone: 678-505-9657
Practice Fax:

1083175533 — DENISE MUNKOMBWE MAKALA MD
Practice Location Address:

1777 NORTHEAST EXPY NE , ZALIK BEHAVIORAL AND MENTAL HEALTH CENTER
BROOKHAVEN, GA
30329-2480

Practice Phone: 404-785-7878
Practice Fax: 704-381-6841

1851253637 — LESLIE ANN HARTNETT LCSW
Practice Location Address:

1575 N EAST EXPY NE
BROOKHAVEN, GA
30329-2317

Practice Phone: 404-785-3689
Practice Fax:

1740043629 — KRISTIE ERIN BOBEK FNP-C
Practice Location Address:

12 EXECUTIVE PARK DR NE FL 5
BROOKHAVEN, GA
30329-2206

Practice Phone: 404-778-3444
Practice Fax:

1609866938 — JOHN EANES II MD
Practice Location Address:

1577 NORTHEAST EXPY NE
BROOKHAVEN, GA
30329-2401

Practice Phone: 404-785-0976
Practice Fax: 404-785-5845

Directions to “PONYA DIAGNOSTICS, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.