Physician Compare National (NPI:1194982579)

HEALTHCARE PROVIDER: ADESUWA RUBY OKESANYA M.D.

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

Individual Professional Information
NPI	1194982579
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9032241658
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170518001749
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	OKESANYA
	Individual professional last name
Provider First Name	ADESUWA
	Individual professional first name
Provider Middle Name	RUBY
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	HOSPITALIST
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	FAMILY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	FAMILY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	296 HAMBURG TPKE
	Group Practice or individual's line 1 address
City	WAYNE
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	074702150
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	310054
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HACKENSACKUMC MOUNTAINSIDE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	310001
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HACKENSACK UNIVERSITY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y