Physician Compare National (NPI:1598892804)

HEALTHCARE PROVIDER: VITALI BREIZER PT

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

Individual Professional Information
NPI	1598892804
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0648313585
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100201000615
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BREIZER
	Individual professional last name
Provider First Name	VITALI
	Individual professional first name
Provider Middle Name	V
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	DUKE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3655 B OLD COURT RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 26
	Group Practice or individual's line 2 address
City	BALTIMORE
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	212083963
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y