Provider Demographics
NPI:1184662645
Name:LASHEEN, SAMY (MD)
Entity Type:Individual
Prefix:
First Name:SAMY
Middle Name:
Last Name:LASHEEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5024 10TH AVE # 1F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-3379
Mailing Address - Country:US
Mailing Address - Phone:718-435-6441
Mailing Address - Fax:718-435-6741
Practice Address - Street 1:5024 10TH AVE # 1F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3379
Practice Address - Country:US
Practice Address - Phone:718-435-6441
Practice Address - Fax:718-435-6741
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224512207L00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8K8781Medicare PIN