Physician Compare National (NPI:1871533646)

HEALTHCARE PROVIDER: INA J KELEMEN MD

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

Individual Professional Information
NPI	1871533646
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8426227786
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110803000561
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KELEMEN
	Individual professional last name
Provider First Name	INA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PEDIATRIC MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PEDIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	21 MAIN ST
	Group Practice or individual's line 1 address
City	FARMINGDALE
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	077271218
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	310073
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	JERSEY SHORE UNIVERSITY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	310052
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	OCEAN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	310075
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MONMOUTH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	310111
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	CENTRASTATE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y