Physician Compare National (NPI:1124282033)

HEALTHCARE PROVIDER: ROLAND JERZY LOSOS 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	1124282033
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0446311070
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111019000112
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LOSOS
	Individual professional last name
Provider First Name	ROLAND
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1992
	Individual professional's medical school graduation year
Primary Specialty	GERIATRIC MEDICINE
	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	155 PARK AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 206
	Group Practice or individual's line 2 address
City	LYNDHURST
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	070711462
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2019334700
	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	310001
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HACKENSACK UNIVERSITY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	310009
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CLARA MAASS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y