Physician Compare National (NPI:1720288335)

HEALTHCARE PROVIDER: ALENA BORISOVNA EASTMAN M.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	1720288335
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830363662
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111114000249
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	EASTMAN
	Individual professional last name
Provider First Name	ALENA
	Individual professional first name
Provider Middle Name	B
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ADVANCED OB-GYN DOCTORS
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7214113950
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	599 MAIN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 2
	Group Practice or individual's line 2 address
City	MANCHESTER
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	060405156
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8602336666
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	070002
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST FRANCIS HOSPITAL & MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y