Physician Compare National (NPI:1356568851)

HEALTHCARE PROVIDER: PETER PAUL TOLISANO JR. PSY.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	1356568851
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0345381364
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100112000595
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TOLISANO
	Individual professional last name
Provider First Name	PETER
	Individual professional first name
Provider Middle Name	P
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
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	2008
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	68 S MAIN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 202
	Group Practice or individual's line 2 address
City	WEST HARTFORD
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	061072445
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M