Physician Compare National (NPI:1467612200)

HEALTHCARE PROVIDER: KANG SOOK SUH DO

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

Individual Professional Information
NPI	1467612200
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4183798705
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140617000008
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SUH
	Individual professional last name
Provider First Name	KANG
	Individual professional first name
Provider Middle Name	SOOK
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	HOSPITALIST
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	STAMFORD HEALTH MEDICAL GROUP INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6901099746
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	307
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	32 STRAWBERRY HILL CT
	Group Practice or individual's line 1 address
City	STAMFORD
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	069022594
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	070006
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	STAMFORD HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330181
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NS/LIJ HS-NORTH SHORE UNIV HOSP AT GLEN COVE
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y