Physician Compare National (NPI:1871709964)

HEALTHCARE PROVIDER: STACY SWATI BANERJEE 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	1871709964
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5890821516
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150608001347
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BANERJEE
	Individual professional last name
Provider First Name	STACY
	Individual professional first name
Provider Middle Name	SWATI
	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	2006
	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	1000 REGENCY CT
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 102
	Group Practice or individual's line 2 address
City	TOLEDO
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	436233074
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2167021122
	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	360068
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PROMEDICA TOLEDO HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360090
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST LUKE'S HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	360262
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MERCY ST ANNE HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	M