Physician Compare National (NPI:1164784443)

HEALTHCARE PROVIDER: JEET BHAIDASNA DO

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

Individual Professional Information
NPI	1164784443
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5799915161
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170207002440
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BHAIDASNA
	Individual professional last name
Provider First Name	JEET
	Individual professional first name
Provider Gender	M
	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	2012
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4 WARNER RD
	Group Practice or individual's line 1 address
City	HAMPTON BAYS
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	119461834
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y