Physician Compare National (NPI:1003918277)

HEALTHCARE PROVIDER: ABED AL-MAWLA JANDALI M.D.

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

Individual Professional Information
NPI	1003918277
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3375627052
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080220000428
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JANDALI
	Individual professional last name
Provider First Name	ABED
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1969
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GENERAL PRACTICE
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	GENERAL SURGERY
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GENERAL PRACTICE, GENERAL SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	13 ARCH ST
	Group Practice or individual's line 1 address
City	GREEN ISLAND
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	121831329
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330180
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAMARITAN HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y