Provider Demographics
NPI:1538104880
Name:KASHLAN, MELISSA JEAN (MD,)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JEAN
Last Name:KASHLAN
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:JEAN
Other - Last Name:LEWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1227 SMITH TOWNSHIP STATE RD
Mailing Address - Street 2:CORNERSTONE CARE
Mailing Address - City:BURGETTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15021-2828
Mailing Address - Country:US
Mailing Address - Phone:725-947-2255
Mailing Address - Fax:
Practice Address - Street 1:1227 SMITH TOWNSHIP STATE RD
Practice Address - Street 2:
Practice Address - City:BURGETTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15021-2828
Practice Address - Country:US
Practice Address - Phone:724-947-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD428631207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011917790002Medicaid
704015OtherUPMC
CA8890OtherRAILROAD MEDICARE GROUP
P006973OtherGATEWAY
001696842OtherHIGHMARK
185119OtherUNISON
185119OtherUNISON
P006973OtherGATEWAY