Physician Compare National (NPI:1780845834)

HEALTHCARE PROVIDER: CHILDEBERT ST LOUIS MD

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

Individual Professional Information
NPI	1780845834
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0244354819
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100903000007
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ST. LOUIS
	Individual professional last name
Provider First Name	CHILDEBERT
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2001
	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	873 ROUTE 45
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 102
	Group Practice or individual's line 2 address
City	NEW CITY
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	109561123
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330006
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST JOSEPH'S MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330264
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST LUKE'S CORNWALL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	310003
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HACKENSACKUMC PALISADES
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	M