Physician Compare National (NPI:1740256395)

HEALTHCARE PROVIDER: EMILY JANE ACKERMAN 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	1740256395
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5496892978
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20091103000096
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ACKERMAN
	Individual professional last name
Provider First Name	EMILY
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	HAHNEMAN MEDICAL COLLEGE OF THE PACIFIC
	Individual professional's medical school
Graduation Year	2002
	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	261 MAIN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 102
	Group Practice or individual's line 2 address
City	NORTH SMITHFIELD
	Group Practice or individual's city
State	RI
	Group Practice or individual's state
Zip Code	028967919
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	410012
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	THE MIRIAM HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	410011
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LANDMARK MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y