Physician Compare National (NPI:1235173873)

HEALTHCARE PROVIDER: LISA C KUGELMAN MD

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

Individual Professional Information
NPI	1235173873
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0345320057
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110218000113
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KUGELMAN
	Individual professional last name
Provider First Name	LISA
	Individual professional first name
Provider Middle Name	CATHERINE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1987
	Individual professional's medical school graduation year
Primary Specialty	DERMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	HARTFORD DERMATOLOGY ASSOCIATES PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8628158334
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	65 MEMORIAL RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 450
	Group Practice or individual's line 2 address
City	WEST HARTFORD
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	061072200
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8605231087
	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	Y