Physician Compare National (NPI:1144747148)

HEALTHCARE PROVIDER: DANAH JACK PT

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

Individual Professional Information
NPI	1144747148
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4789945452
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180221002135
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JACK
	Individual professional last name
Provider First Name	DANAH
	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	2008
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	9103 WOODMORE CTR DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 157
	Group Practice or individual's line 2 address
City	LANHAM
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	207061653
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y