Provider Demographics
NPI:1962130690
Name:NEWSHA DERMATOLOGY PLUS COSMETICS INC.
Entity type:Organization
Organization Name:NEWSHA DERMATOLOGY PLUS COSMETICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NEWSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAJEVARDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-905-7933
Mailing Address - Street 1:2801 NE 213TH ST STE 1005
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1266
Mailing Address - Country:US
Mailing Address - Phone:305-330-9933
Mailing Address - Fax:305-250-2610
Practice Address - Street 1:2801 NE 213TH ST STE 1005
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1266
Practice Address - Country:US
Practice Address - Phone:305-330-9933
Practice Address - Fax:305-250-2610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-10
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty