Physician Compare National (NPI:1407874696)

HEALTHCARE PROVIDER: TIMOTHY N TRIBIANO PHD

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

Individual Professional Information
NPI	1407874696
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2961496401
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070517000321
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TRIBIANO
	Individual professional last name
Provider First Name	TIMOTHY
	Individual professional first name
Provider Middle Name	NICHOLAS
	Individual professional middle name
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	2002
	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	2401 W BAY DR BLDG
	Group Practice or individual's line 1 address
Line 2 Street Address	100 SUITE 117
	Group Practice or individual's line 2 address
City	LARGO
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	337704902
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y