Physician Compare National (NPI:1699719112)

HEALTHCARE PROVIDER: EDWARD C WARREN JR. 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	1699719112
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5092886499
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080804000138
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WARREN
	Individual professional last name
Provider First Name	EDWARD
	Individual professional first name
Provider Middle Name	C
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1984
	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	24 HANOVER ST
	Group Practice or individual's line 1 address
Line 2 Street Address	3A
	Group Practice or individual's line 2 address
City	LEBANON
	Group Practice or individual's city
State	NH
	Group Practice or individual's state
Zip Code	037661334
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6034482111
	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	M