Provider Demographics
NPI:1821437823
Name:WASSEF, INAS LATIF SHAKER (MD)
Entity Type:Individual
Prefix:DR
First Name:INAS
Middle Name:LATIF SHAKER
Last Name:WASSEF
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 1:40C MEADOWLANDS PKWY
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-2946
Mailing Address - Country:US
Mailing Address - Phone:201-552-2256
Mailing Address - Fax:201-552-2358
Practice Address - Street 1:714 10TH ST
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-2921
Practice Address - Country:US
Practice Address - Phone:201-552-2256
Practice Address - Fax:201-552-2358
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270837208000000X
NJ25MA09372400208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics