Physician Compare National (NPI:1922283696)

HEALTHCARE PROVIDER: STACEY K ROSELLON MSPT

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

Individual Professional Information
NPI	1922283696
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4183921083
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160321000533
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ROSELLON
	Individual professional last name
Provider First Name	STACEY
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
	Individual professional's medical school
Graduation Year	2004
	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
Organization Legal Name	HOME PHYSICAL THERAPY SOLUTIONS P.C.
	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	0941340053
	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	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	111 W OLD COUNTRY RD
	Group Practice or individual's line 1 address
Line 2 Street Address	UNIT 1
	Group Practice or individual's line 2 address
City	HICKSVILLE
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	118014036
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5164334570
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y