Physician Compare National (NPI:1609849116)

HEALTHCARE PROVIDER: SANDRA MOORE CHAMBERLIN M.S.

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

Individual Professional Information
NPI	1609849116
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0244235174
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060927000028
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHAMBERLIN
	Individual professional last name
Provider First Name	SANDRA
	Individual professional first name
Provider Middle Name	MOORE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PENNSYLVANIA COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	QUALIFIED AUDIOLOGIST
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1215 W SOUTHERN AVE
	Group Practice or individual's line 1 address
City	SOUTH WILLIAMSPORT
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	177027142
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y