Physician Compare National (NPI:1477098606)

HEALTHCARE PROVIDER: ROBERT TERRELONGE RN

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

Individual Professional Information
NPI	1477098606
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5991033771
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190819002629
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TERRELONGE
	Individual professional last name
Provider First Name	ROBERT
	Individual professional first name
Provider Name Suffix Text	JR.
	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	2018
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	315 BEACH 9TH ST
	Group Practice or individual's line 1 address
City	FAR ROCKAWAY
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	116915507
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M