Physician Compare National (NPI:1780755769)

HEALTHCARE PROVIDER: MARLENE A CHELSO APRN

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

Individual Professional Information
NPI	1780755769
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8426233974
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110426000732
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHELSO
	Individual professional last name
Provider First Name	MARLENE
	Individual professional first name
Provider Middle Name	A
	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	1996
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	152 DEER HILL AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 207
	Group Practice or individual's line 2 address
City	DANBURY
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	068107766
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2037759484
	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