Physician Compare National (NPI:1568414993)

HEALTHCARE PROVIDER: KENNETH F MARICI MD

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

Individual Professional Information
NPI	1568414993
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4284539388
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20031203000075
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MARICI
	Individual professional last name
Provider First Name	KENNETH
	Individual professional first name
Provider Middle Name	F
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	TEMPLE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	11 PROSPECT HILL RD
	Group Practice or individual's line 1 address
City	NEW MILFORD
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	067763695
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	070033
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	DANBURY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y