Physician Compare National (NPI:1134326887)

HEALTHCARE PROVIDER: NINA MIRSAKOV 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	1134326887
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1951493311
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070815000675
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MIRSAKOV
	Individual professional last name
Provider First Name	NINA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
	Individual professional's medical school
Graduation Year	2004
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	8 W 38TH ST
	Group Practice or individual's line 1 address
Line 2 Street Address	RM 503
	Group Practice or individual's line 2 address
City	NEW YORK
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	100186368
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330259
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MERCY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330106
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NS/LIJ HS-NORTH SHORE UNIVERSITY HOSPITAL AT MANHASSET
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	330198
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SOUTH NASSAU COMMUNITIES HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y