Physician Compare National (NPI:1235465089)

HEALTHCARE PROVIDER: REZA MESBAH 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	1235465089
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0840461877
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110922000288
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MESBAH
	Individual professional last name
Provider First Name	REZA
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	88 01 PARSONS BLVD
	Group Practice or individual's line 1 address
City	JAMAICA
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	114323841
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y