Physician Compare National (NPI:1962765461)

HEALTHCARE PROVIDER: MANISH B PATEL DO

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

Individual Professional Information
NPI	1962765461
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8224359963
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20171228000329
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PATEL
	Individual professional last name
Provider First Name	MANISH
	Individual professional first name
Provider Middle Name	B
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
	Individual professional's medical school
Graduation Year	2012
	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
Secondary Specialty 1	PAIN MANAGEMENT
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PAIN MANAGEMENT
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	680 KINDERKAMACK RD
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	ORADELL
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	076491600
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y