Physician Compare National (NPI:1427003250)

HEALTHCARE PROVIDER: MARTIN SAMILLANO MALALUAN III RPT

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

Individual Professional Information
NPI	1427003250
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2567473978
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060524000183
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MALALUAN
	Individual professional last name
Provider First Name	MARTIN
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Name Suffix Text	III
	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	1995
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1182 TEANECK RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 101
	Group Practice or individual's line 2 address
City	TEANECK
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	076664838
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y