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Individual

FAWAZ KASHLAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5 SPRINGHOUSE RD, OCEAN, NJ 07712-3727
(732) 922-4763
Mailing address
66 WEST GILBERT ST, RED BANK, NJ 07701

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
25MA06203200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7401906
NJ
Enumeration date
05/09/2007
Last updated
05/14/2008
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