Individual Professional Information |
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NPI
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1861550691
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Unique healthcare provider (clinician) ID assigned by NPPES
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PECOS UID
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2567654007
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Unique individual clinician ID assigned by PECOS
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Professional Enrollment ID
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I20101206000597
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Unique ID for the individual professional enrollment that is the source for the data in the observation
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Provider Last Name
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ISKANDER
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Individual professional last name
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Provider First Name
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MAGDY
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Individual professional first name
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Provider Middle Name
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K
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Individual professional middle name
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Provider Gender
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M
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The provider's gender if the provider is a person.
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Hospital(s) Affiliation Information |
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Hospital Affiliation CCN 1
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390211
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Medicare CCN of hospital where individual professional provides service 1
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Hospital Affiliation LBN 1
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SHARON REGIONAL HEALTH SYSTEM
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Legal business name of hospital where individual professional provides service 1
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Hospital Affiliation CCN 2
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360064
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Medicare CCN of hospital where individual professional provides service 2
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Hospital Affiliation LBN 2
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ST ELIZABETH YOUNGSTOWN HOSPITAL
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Legal business name of hospital where individual professional provides service 2
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Hospital Affiliation CCN 3
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360276
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Medicare CCN of hospital where individual professional provides service 3
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Hospital Affiliation LBN 3
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HMHP ST ELIZABETH BOARDMAN HEALTH CENTER
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Legal business name of hospital where individual professional provides service 3
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Hospital Affiliation CCN 4
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390178
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Medicare CCN of hospital where individual professional provides service 4
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Hospital Affiliation LBN 4
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UPMC HORIZON
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Legal business name of hospital where individual professional provides service 4
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Hospital Affiliation CCN 5
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360161
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Medicare CCN of hospital where individual professional provides service 5
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Hospital Affiliation LBN 5
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ST JOSEPH WARREN HOSPITAL
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Legal business name of hospital where individual professional provides service 5
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Professional Accepts Medicare Assignment
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Y
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