Physician Compare National (NPI:1982866513)

HEALTHCARE PROVIDER: VAUGHN EASTON WHITTAKER MBBS

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

Individual Professional Information
NPI	1982866513
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3779629639
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20091006000616
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WHITTAKER
	Individual professional last name
Provider First Name	VAUGHN
	Individual professional first name
Provider Middle Name	E
	Individual professional middle 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	1996
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GENERAL SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GENERAL SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	ESSEN MEDICAL URGICARE, PLLC
	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	4385960897
	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	60
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	8989 UNION TPKE
	Group Practice or individual's line 1 address
City	GLENDALE
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	113858010
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7188478500
	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	330240
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HARLEM HOSPITAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y