Physician Compare National (NPI:1225003536)

HEALTHCARE PROVIDER: MARK P PANDOLFO DC

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

Individual Professional Information
NPI	1225003536
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7315029980
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120201000423
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PANDOLFO
	Individual professional last name
Provider First Name	MARK
	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	LOGAN COLLEGE OF CHIROPRACTIC
	Individual professional's medical school
Graduation Year	1997
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	175 W COHAWKIN RD
	Group Practice or individual's line 1 address
City	CLARKSBORO
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	080201145
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8564235559
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M