Physician Compare National (NPI:1578638573)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1578638573
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5496807406
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090722000000
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ZAKARIYYA
	Individual professional last name
Provider First Name	HASAN
	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	1978
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	HOSPITALIST
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	HOSPITALIST
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	946 S 1ST ST
	Group Practice or individual's line 1 address
City	FULTON
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	130694907
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3155922300
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330203
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CROUSE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330175
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CORTLAND REGIONAL MEDICAL CENTER, INC
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	330218
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	OSWEGO HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y