1720268162 NPI number — RICHARD J. STERNBERG MD, FAAOS, P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720268162 NPI number — RICHARD J. STERNBERG MD, FAAOS, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICHARD J. STERNBERG MD, FAAOS, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1720268162
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 NORMAN ESKRIDGE HWY
Provider Second Line Business Mailing Address:
PO BOX 419
Provider Business Mailing Address City Name:
SEAFORD
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19973-1726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-629-7900
Provider Business Mailing Address Fax Number:
302-629-2099

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 NORMAN ESRIDGE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEAFORD
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19973-1726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-629-7900
Provider Business Practice Location Address Fax Number:
302-629-2099
Provider Enumeration Date:
11/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STERNBERG
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
JOEL
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
302-629-7900

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  C10005745 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0000983201 . This is a "MEDICAID INDV. NUMBER" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 1568401305 . This is a "NPI INDIVIDUAL NUMBER" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 1000015377 . This is a "MEDICAID GROUP NUMBER" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 00B313R53 . This is a "MEDICARE INDV. NUMBER" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: G00953 . This is a "MEDICARE GROUP NUMBER" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 207X00000X . This is a "MEDICAID TAXONOMY NUMBER" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".




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