Physician Compare National (NPI:1891886438)

HEALTHCARE PROVIDER: IVAN HERNANDEZ PT

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

Individual Professional Information
NPI	1891886438
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1052499613
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080422000776
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HERNANDEZ
	Individual professional last name
Provider First Name	IVAN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2001
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1034 N BROADWAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 2
	Group Practice or individual's line 2 address
City	YONKERS
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	107011329
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y