Physician Compare National (NPI:1063832467)

HEALTHCARE PROVIDER: ELISHEVA RUBINOVA D.O.

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

Individual Professional Information
NPI	1063832467
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3971862970
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180122000224
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RUBINOVA
	Individual professional last name
Provider First Name	ELISHEVA
	Individual professional first 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	2014
	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	OSTEOPATHIC MANIPULATIVE MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	OSTEOPATHIC MANIPULATIVE MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	CITY MEDICAL OF UPPER EAST SIDE, PLLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0648465039
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	544
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	9119 QUEENS BLVD
	Group Practice or individual's line 1 address
City	ELMHURST
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	113735531
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6466471253
	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