Physician Compare National (NPI:1396806097)

HEALTHCARE PROVIDER: ADDY NNSEWO M.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	1396806097
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8022290295
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110309000287
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	NNSEWO
	Individual professional last name
Provider First Name	ADDY
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	13130 MERRICK BLVD
	Group Practice or individual's line 1 address
City	JAMAICA
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	114344134
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330396
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WOODHULL MEDICAL AND MENTAL HEALTH CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330397
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	INTERFAITH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y