1821149329 NPI number — DR. CHRISTINE B STERN D.P.M.

Table of content: DR. CHRISTINE B STERN D.P.M. (NPI 1821149329)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821149329 NPI number — DR. CHRISTINE B STERN D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STERN
Provider First Name:
CHRISTINE
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.P.M.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821149329
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 MIDDLE COUNTRY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORAM
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11727-4412
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-696-9636
Provider Business Mailing Address Fax Number:
631-696-9635

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 MIDDLE COUNTRY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORAM
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11727-4412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-696-9636
Provider Business Practice Location Address Fax Number:
631-696-9635
Provider Enumeration Date:
01/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0131X , with the licence number:  N004301 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 13-3487494 . This is a "MAGNACARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 198508P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P04461 . This is a "BLUE CROSS & BLUE SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2132775 . This is a "VYTRA HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4231526 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: AJ45250 . This is a "MDNY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: PO4301-9 . This is a "WORKER'S COMPENSATION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 13-3487494 . This is a "ISLAND GROUP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 13-3487494 . This is a "THE EMPIRE PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: CS594 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01072068 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1400081 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 13-3487494 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 480015215 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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