Physician Compare National (NPI:1831288851)

HEALTHCARE PROVIDER: DORIT BEN-MOHA DO

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

Individual Professional Information
NPI	1831288851
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7911023726
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101006000262
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BEN-MOHA
	Individual professional last name
Provider First Name	DORIT
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	420 N BROADWAY
	Group Practice or individual's line 1 address
City	JERICHO
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	117532135
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330331
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PLAINVIEW HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330332
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHSLI ST JOSEPH HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y