Physician Compare National (NPI:1205149689)

HEALTHCARE PROVIDER: IZABELLE REYHANIAN HAKIM LCSW

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

Individual Professional Information
NPI	1205149689
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9133302680
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110322000394
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HAKIM
	Individual professional last name
Provider First Name	IZABELLE
	Individual professional first name
Provider Middle Name	REYHANIAN
	Individual professional middle 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	2016
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	55 NORTHERN BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 406
	Group Practice or individual's line 2 address
City	GREAT NECK
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	110214058
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	331312
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	DELAWARE VALLEY HOSPITAL, INC
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y