Physician Compare National (NPI:1366720351)

HEALTHCARE PROVIDER: JULIE L STACHURA AUD

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

Individual Professional Information
NPI	1366720351
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0446423289
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111024000279
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STACHURA
	Individual professional last name
Provider First Name	JULIE
	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	STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	QUALIFIED AUDIOLOGIST
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	DIVERSIFIED SERVICES FOR OCCUPATIONAL THERAPY PHYSICAL THER
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0143204917
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	17
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	4855 CAMP RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 400
	Group Practice or individual's line 2 address
City	HAMBURG
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	140752600
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7166467801
	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