Physician Compare National (NPI:1255589461)

HEALTHCARE PROVIDER: YULI FRADKIN 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	1255589461
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5496936924
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140924000085
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FRADKIN
	Individual professional last name
Provider First Name	YULI
	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	1994
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1564 LEMOINE AVE
	Group Practice or individual's line 1 address
City	FORT LEE
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	070245635
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	310028
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NEWTON MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y