Provider Demographics
NPI:1447577457
Name:ABDELSHAHED, MINA (MD)
Entity Type:Individual
Prefix:DR
First Name:MINA
Middle Name:
Last Name:ABDELSHAHED
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 1:210 W SAINT GEORGES AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-3900
Mailing Address - Country:US
Mailing Address - Phone:908-486-1111
Mailing Address - Fax:908-486-2723
Practice Address - Street 1:210 W SAINT GEORGES AVE FL 2
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-3900
Practice Address - Country:US
Practice Address - Phone:908-486-1111
Practice Address - Fax:908-486-2723
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA09816700207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program