Physician Compare National (NPI:1861473597)

HEALTHCARE PROVIDER: MARINA WASYLYSHYN 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	1861473597
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6103952908
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100331000756
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WASYLYSHYN
	Individual professional last name
Provider First Name	MARINA
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	49 COURT ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 2
	Group Practice or individual's line 2 address
City	BINGHAMTON
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	139013236
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6077704071
	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	330394
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	UNITED HEALTH SERVICES HOSPITALS, INC
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y