Healthcare Provider Details

I. General information

NPI: 1538104880
Provider Name (Legal Business Name): MELISSA JEAN KASHLAN M.D,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA JEAN LEWIN

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 11/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1227 SMITH TOWNSHIP STATE RD
BURGETTSTOWN PA
15021-2828
US

IV. Provider business mailing address

1227 SMITH TOWNSHIP STATE RD CORNERSTONE CARE
BURGETTSTOWN PA
15021-2828
US

V. Phone/Fax

Practice location:
  • Phone: 724-947-2255
  • Fax:
Mailing address:
  • Phone: 725-947-2255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD428631
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: