Physician Compare National (NPI:1902098460)

HEALTHCARE PROVIDER: MOHAMMAD CHELEHMALZADEH 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	1902098460
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4183764798
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160128001594
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHELEHMALZADEH
	Individual professional last name
Provider First Name	MOHAMMAD
	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	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	EMERGENCY PHYSICIANS OF CONNECTICUT PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8820390214
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	33
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	64 ROBBINS ST
	Group Practice or individual's line 1 address
City	WATERBURY
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	067082613
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2035737306
	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	070005
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WATERBURY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y