Physician Compare National (NPI:1154300150)

HEALTHCARE PROVIDER: MAMMEN P ZACHARIAH 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	1154300150
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3870789001
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101130000290
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ZACHARIAH
	Individual professional last name
Provider First Name	MAMMEN
	Individual professional first name
Provider Middle Name	P
	Individual professional middle 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	1975
	Individual professional's medical school graduation year
Primary Specialty	INTERVENTIONAL CARDIOLOGY
	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
Secondary Specialty 2	INTERNAL MEDICINE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CARDIOVASCULAR DISEASE (CARDIOLOGY), INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	NORTH BROWARD HOSPITAL DISTRICT
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	3577472422
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	129
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	6405 N FEDERAL HWY
	Group Practice or individual's line 1 address
City	FORT LAUDERDALE
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	333081412
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9549585200
	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	100200
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BROWARD HEALTH IMPERIAL POINT
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y