Provider Demographics
NPI:1225392095
Name:LAJEVARDI, NEWSHA (MD)
Entity Type:Individual
Prefix:
First Name:NEWSHA
Middle Name:
Last Name:LAJEVARDI
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 1:2801 NE 213TH ST STE 1005
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1266
Mailing Address - Country:US
Mailing Address - Phone:305-905-7933
Mailing Address - Fax:
Practice Address - Street 1:2801 NE 213TH ST STE 1005
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1266
Practice Address - Country:US
Practice Address - Phone:305-330-9933
Practice Address - Fax:305-250-2610
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME135989207N00000X
RIMD15616207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology