Provider Demographics
NPI:1477590644
Name:LASHIN, WALEED S (MD)
Entity Type:Individual
Prefix:DR
First Name:WALEED
Middle Name:S
Last Name:LASHIN
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 1:1414 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2157
Mailing Address - Country:US
Mailing Address - Phone:973-253-6000
Mailing Address - Fax:973-253-6009
Practice Address - Street 1:1414 MAIN AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011
Practice Address - Country:US
Practice Address - Phone:973-253-6000
Practice Address - Fax:973-427-4419
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07809300207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0064394Medicaid
NJI28596Medicare UPIN
NJ090415Medicare ID - Type Unspecified