Physician Compare National (NPI:1790705945)

HEALTHCARE PROVIDER: ROBERT M. POTENZA 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	1790705945
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0446359871
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070625000740
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	POTENZA
	Individual professional last name
Provider First Name	ROBERT
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1966
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	2800 BRUCKNER BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 306
	Group Practice or individual's line 2 address
City	BRONX
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	104651972
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7185979595
	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	330059
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MONTEFIORE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y