Physician Compare National (NPI:1285896514)

HEALTHCARE PROVIDER: JENNIFER LEE LAKIS D.O.

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

Individual Professional Information
NPI	1285896514
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7719170489
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101026001089
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LAKIS
	Individual professional last name
Provider First Name	JENNIFER
	Individual professional first name
Provider Middle Name	L
	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 NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
	Individual professional's medical school
Graduation Year	2004
	Individual professional's medical school graduation year
Primary Specialty	OSTEOPATHIC MANIPULATIVE MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	10 CUMBERLAND ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 3
	Group Practice or individual's line 2 address
City	BRUNSWICK
	Group Practice or individual's city
State	ME
	Group Practice or individual's state
Zip Code	040111932
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	200009
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MAINE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y