Physician Compare National (NPI:1265445050)

HEALTHCARE PROVIDER: PAUL T GAMBARDELLA DPM

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

Individual Professional Information
NPI	1265445050
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7618079732
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070220000783
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GAMBARDELLA
	Individual professional last name
Provider First Name	PAUL
	Individual professional first name
Provider Middle Name	T
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DPM
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	TEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	329 E MAIN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 110
	Group Practice or individual's line 2 address
City	YALESVILLE
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	064922291
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2032656677
	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