Physician Compare National (NPI:1629019682)

HEALTHCARE PROVIDER: ROBERT GUSTAV HAAK O.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	1629019682
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5395869440
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100826000816
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HAAK
	Individual professional last name
Provider First Name	ROBERT
	Individual professional first name
Provider Middle Name	G
	Individual professional middle name
Provider Gender	M
	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	1999
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	900 W VALLEY RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 601
	Group Practice or individual's line 2 address
City	WAYNE
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	190871825
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6106883433
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y