Physician Compare National (NPI:1457970519)

HEALTHCARE PROVIDER: CAMERON PELLETIER DPT

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

Individual Professional Information
NPI	1457970519
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668802687
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200611000393
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PELLETIER
	Individual professional last name
Provider First Name	CAMERON
	Individual professional first 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	2019
	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	BO COTTE NORTE SECTOR CAMPO ALEGRE CARR 2 KM
	Group Practice or individual's line 1 address
Line 2 Street Address	4 EDIFICIO LAS VEGAS NUM. 420
	Group Practice or individual's line 2 address
City	MANAT
	Group Practice or individual's city
State	PR
	Group Practice or individual's state
Zip Code	006749801
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7878547060
	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