Physician Compare National (NPI:1427304948)

HEALTHCARE PROVIDER: NINA CRISELDA NICDAO EVANGELISTA PT, CEEAA

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

Individual Professional Information
NPI	1427304948
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2860643608
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20121105000062
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	EVANGELISTA
	Individual professional last name
Provider First Name	NINA CRISELDA
	Individual professional first name
Provider Middle Name	NICDAO
	Individual professional middle 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	2004
	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	6955 OAKLAND MILLS RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE E
	Group Practice or individual's line 2 address
City	COLUMBIA
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	210455849
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y