Physician Compare National (NPI:1669615308)

HEALTHCARE PROVIDER: ROBERT U MMEREOLE 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	1669615308
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7113189507
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160504000254
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MMEREOLE
	Individual professional last name
Provider First Name	ROBERT
	Individual professional first name
Provider Middle Name	UZODIMMA
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	HOWARD UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	6101 KENNEDY BLVD E
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1
	Group Practice or individual's line 2 address
City	WEST NEW YORK
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	070933902
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330023
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	VASSAR BROTHERS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y