Active NPI
Fawaz Kashlan
- Neonatal-Perinatal Medicine Physician
- Ocean, NJ
National Provider Identifier
1205040425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 25MA06203200
- Practice address
- 5 Springhouse Rd
Ocean, NJ 07712-3727 - Phone
- (732) 922-4763
- NPI assigned
- May 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 25MA06203200 | NJ | Primary |
Addresses
Primary practice location
5 Springhouse Rd
Ocean, NJ 07712-3727
Mailing address
66 West Gilbert St
Red Bank, NJ 07701
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7401906 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA06203200 | NJ | MD | Neonatal-Perinatal Medicine Physician |
Interoperability endpoints
- fkashlan189835@ahs.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210723200000",
"number": "1205040425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 WEST GILBERT ST",
"city": "RED BANK",
"state": "NJ",
"postal_code": "07701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 SPRINGHOUSE RD",
"city": "OCEAN",
"state": "NJ",
"postal_code": "077123727",
"telephone_number": "732-922-4763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASHLAN",
"first_name": "FAWAZ",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-09",
"last_updated": "2008-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "NJ",
"license": "25MA06203200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7401906",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ocean, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.