Physician Compare National (NPI:1578683660)

HEALTHCARE PROVIDER: ADEEL HASAN AZAM M.D.

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

Individual Professional Information
NPI	1578683660
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8325216104
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190725001772
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	AZAM
	Individual professional last name
Provider First Name	ADEEL
	Individual professional first name
Provider Middle Name	HASAN
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	CLINICAL HEALTH CARE ASSOCIATES OF NEW JERSEY PC
	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	0749180198
	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	363
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1006 MANTUA PIKE
	Group Practice or individual's line 1 address
City	WOODBURY
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	080971221
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8566868282
	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	390179
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHESTER COUNTY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	390127
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PHOENIXVILLE HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y