Physician Compare National (NPI:1053370130)

HEALTHCARE PROVIDER: JOHAM SENIOR MARINO MD

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

Individual Professional Information
NPI	1053370130
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5597951830
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101129000215
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SENIOR MARINO
	Individual professional last name
Provider First Name	JOHAM
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY CENTRAL DEL CARIBE ESCUELA DE MEDICINA
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	GASTROENTEROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	BAYAMON MEDICAL PLAZA
	Group Practice or individual's line 1 address
Line 2 Street Address	CARR 2 SUITE 104 A
	Group Practice or individual's line 2 address
City	BAYAMON
	Group Practice or individual's city
State	PR
	Group Practice or individual's state
Zip Code	00959
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7877989522
	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