Physician Compare National (NPI:1588857809)

HEALTHCARE PROVIDER: STEPHANIE DESSI KILEY O.T. CLT/LANA

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

Individual Professional Information
NPI	1588857809
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7911084009
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180821001852
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KILEY
	Individual professional last name
Provider First Name	STEPHANIE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2001
	Individual professional's medical school graduation year
Primary Specialty	OCCUPATIONAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1372 SUMMER ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 200
	Group Practice or individual's line 2 address
City	STAMFORD
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	069055365
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y