Physician Compare National (NPI:1194977603)

HEALTHCARE PROVIDER: ZHAODI GONG MD, PHD

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

Individual Professional Information
NPI	1194977603
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830499367
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160621000428
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GONG
	Individual professional last name
Provider First Name	ZHAODI
	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	2003
	Individual professional's medical school graduation year
Primary Specialty	ANESTHESIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PAIN MANAGEMENT
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PAIN MANAGEMENT
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	60 KATONA DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 25
	Group Practice or individual's line 2 address
City	FAIRFIELD
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	068243544
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y