Physician Compare National (NPI:1356576961)

HEALTHCARE PROVIDER: LUIS H. MORA 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	1356576961
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6709918329
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100719000048
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MORA
	Individual professional last name
Provider First Name	LUIS
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2007
	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	2749 HYLAN BLVD
	Group Practice or individual's line 1 address
City	STATEN ISLAND
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	103064656
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7186680922
	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