Physician Compare National (NPI:1659392363)

HEALTHCARE PROVIDER: DEBORAH A CASERTA-BRUNSON MD

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

Individual Professional Information
NPI	1659392363
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7214124361
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101215000309
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CASERTA-BRUNSON
	Individual professional last name
Provider First Name	DEBORAH
	Individual professional first name
Provider Middle Name	A
	Individual professional middle 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	1982
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	234 BROAD ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1
	Group Practice or individual's line 2 address
City	MILFORD
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	064603278
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	070010
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BRIDGEPORT HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	070022
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	YALE-NEW HAVEN HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y