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Physician Compare National (NPI:1003966623)

HEALTHCARE PROVIDER: LISA CLAIRE PELTON LCSWR

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

Individual Professional Information

NPI 1003966623
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 3577699636
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20100327000390
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name PELTON
Individual professional last name
Provider First Name LISA
Individual professional first name
Provider Middle Name C
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1993
Individual professional's medical school graduation year
Primary Specialty CLINICAL SOCIAL WORKER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 272 N BEDFORD RD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 206
Group Practice or individual's line 2 address
City MOUNT KISCO
Group Practice or individual's city
State NY
Group Practice or individual's state
Zip Code 105491168
Group Practice or individual's zip code (9 digits when available)
Phone Number 9148640626
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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