Physician Compare National (NPI:1942417902)

HEALTHCARE PROVIDER: FANG TIAN 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	1942417902
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2567644172
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110303000058
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TIAN
	Individual professional last name
Provider First Name	FANG
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1991
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4161 KISSENA BLVD E
	Group Practice or individual's line 1 address
City	FLUSHING
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	113553105
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y