Physician Compare National (NPI:1770715732)

HEALTHCARE PROVIDER: KELLY MARIE SCHIAVONE LCSW

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

Individual Professional Information
NPI	1770715732
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8224390018
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180314001019
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SCHIAVONE
	Individual professional last name
Provider First Name	KELLY
	Individual professional first name
Provider Middle Name	MARIE
	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	2001
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	602 S BETHLEHEM PIKE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B BLDG B KELLY M BOSTICK
	Group Practice or individual's line 2 address
City	AMBLER
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	190025809
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2152790983
	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	Y