Physician Compare National (NPI:1003039611)

HEALTHCARE PROVIDER: MARIELA BETINA PEROSINO D.C.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1003039611
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0648395319
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100917000821
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PEROSINO
	Individual professional last name
Provider First Name	MARIELA
	Individual professional first name
Provider Middle Name	BETINA
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LIFE CHIROPRACTIC COLLEGE
	Individual professional's medical school
Graduation Year	2001
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	611 HOLCOMB BRIDGE RD A
	Group Practice or individual's line 1 address
City	ROSWELL
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	300761769
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y