Physician Compare National (NPI:1104891803)

HEALTHCARE PROVIDER: STEPHEN F KONIGSBERG M.D.

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

Individual Professional Information
NPI	1104891803
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8426193608
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100324000482
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KONIGSBERG
	Individual professional last name
Provider First Name	STEPHEN
	Individual professional first name
Provider Middle Name	F
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	HARVARD MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	1962
	Individual professional's medical school graduation year
Primary Specialty	VASCULAR SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GENERAL SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GENERAL SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	215 N CTR DR
	Group Practice or individual's line 1 address
City	NORTH BRUNSWICK
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	089024247
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	310070
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAINT PETER'S UNIVERSITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y