Medical School Information |
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Medical School Name
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OTHER
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Individual professional's medical school
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Graduation Year
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1979
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Individual professional's medical school graduation year
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Primary Specialty
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PULMONARY DISEASE
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Primary medical specialty reported by the individual professional in the selected enrollment
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Secondary Specialty 1
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CRITICAL CARE (INTENSIVISTS)
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First secondary medical specialty reported by the individual professional in the selected enrollment
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Secondary Specialty 2
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INTERNAL MEDICINE
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Second secondary medical specialty reported by the individual professional in the selected enrollment
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All Secondary Specialties
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CRITICAL CARE (INTENSIVISTS), INTERNAL MEDICINE
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All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas
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Hospital(s) Affiliation Information |
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Hospital Affiliation CCN 1
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310070
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Medicare CCN of hospital where individual professional provides service 1
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Hospital Affiliation LBN 1
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SAINT PETER'S UNIVERSITY HOSPITAL
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Legal business name of hospital where individual professional provides service 1
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Hospital Affiliation CCN 2
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160110
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Medicare CCN of hospital where individual professional provides service 2
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Hospital Affiliation LBN 2
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ALLEN HOSPITAL
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Legal business name of hospital where individual professional provides service 2
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Hospital Affiliation CCN 3
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340050
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Medicare CCN of hospital where individual professional provides service 3
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Hospital Affiliation LBN 3
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SOUTHEASTERN REGIONAL MEDICAL CENTER
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Legal business name of hospital where individual professional provides service 3
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Hospital Affiliation CCN 4
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381321
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Medicare CCN of hospital where individual professional provides service 4
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Hospital Affiliation LBN 4
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GRANDE RONDE HOSPITAL
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Legal business name of hospital where individual professional provides service 4
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Hospital Affiliation CCN 5
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310039
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Medicare CCN of hospital where individual professional provides service 5
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Hospital Affiliation LBN 5
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RARITAN BAY MEDICAL CENTER PERTH AMBOY DIVISION
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Legal business name of hospital where individual professional provides service 5
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Professional Accepts Medicare Assignment
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Y
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