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Physician Compare National (NPI:1265871933)

HEALTHCARE PROVIDER: NELLYA GENDELMAN O.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 1265871933
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 5395988471
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20130821001016
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name GENDELMAN
Individual professional last name
Provider First Name NELLYA
Individual professional first name
Provider Middle Name S
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 HOUSTON - COLLEGE OF OPTOMETRY
Individual professional's medical school
Graduation Year 2013
Individual professional's medical school graduation year
Primary Specialty OPTOMETRY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 1301 W GLADE RD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 196
Group Practice or individual's line 2 address
City EULESS
Group Practice or individual's city
State TX
Group Practice or individual's state
Zip Code 760395419
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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