Physician Compare National (NPI:1801843909)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1801843909
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0547340374
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080107000644
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	POLEWAC
	Individual professional last name
Provider First Name	BRENDA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PENNSYLVANIA COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	7955 AIRPORT PULLING RD N
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 104
	Group Practice or individual's line 2 address
City	NAPLES
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	341091794
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2395947568
	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