Physician Compare National (NPI:1033378161)

HEALTHCARE PROVIDER: NITIN RAJKUMAR MARIWALLA MD, MPH, MS

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

Individual Professional Information
NPI	1033378161
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7911208764
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170826000299
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MARIWALLA
	Individual professional last name
Provider First Name	NITIN
	Individual professional first name
Provider Middle Name	RAJKUMAR
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TULANE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	NEUROSURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1175 MONTAUK HWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 3
	Group Practice or individual's line 2 address
City	WEST ISLIP
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	117954939
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6315009400
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330182
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST FRANCIS HOSPITAL - THE HEART CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y