Physician Compare National (NPI:1073534434)

HEALTHCARE PROVIDER: KHOSROW ALYESHMERNI 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	1073534434
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1052340981
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050810000847
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ALYESHMERNI
	Individual professional last name
Provider First Name	KHOSROW
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1976
	Individual professional's medical school graduation year
Primary Specialty	ENDOCRINOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	10828 68TH DR
	Group Practice or individual's line 1 address
City	FOREST HILLS
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	113752951
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7188960100
	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	330106
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NS/LIJ HS-NORTH SHORE UNIVERSITY HOSPITAL AT MANHASSET
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y