Provider Demographics
NPI:1770637977
Name:LUSHA, XHELAL (MD)
Entity Type:Individual
Prefix:MR
First Name:XHELAL
Middle Name:
Last Name:LUSHA
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 1:595 COUNTY AVE
Mailing Address - Street 2:BLDG 10 HUDSON COUNTY MEADOWVIEW PSYCHIATRIC HOSPITAL
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094
Mailing Address - Country:US
Mailing Address - Phone:201-319-3667
Mailing Address - Fax:201-319-3616
Practice Address - Street 1:595 COUNTY AVE
Practice Address - Street 2:BLDG 10 HUDSON COUNTY MEADOWVIEW PSYCHIATRIC HOSPITAL
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094
Practice Address - Country:US
Practice Address - Phone:201-319-3667
Practice Address - Fax:201-319-3616
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04502400208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LU175153Medicare ID - Type Unspecified
E98055Medicare UPIN