MEDICARE: ROBERT GABRIEL STERN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	25MA06964800	NJ
2	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician	198077	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134272495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT GABRIEL STERN MD

Provider Business Mailing Address
First Line	:	10 DOROLEE DRIVE
Second Line	:
City	:	EAST BRUNSWICH
State	:	NJ
Zip	:	08816
Country	:	US
Telephone Number	:	732-881-3280
Fax Number	:	732-951-1795

Provider Business Practice Location Address
First Line	:	376 SEGUINE AVE
Second Line	:	STATEN ISLAND UNIVERSITY HOSPITAL
City	:	STATEN ISLAND
State	:	NY
Zip	:	10309-3942
Country	:	US
Telephone Number	:	718-226-2351
Fax Number	:	718-226-2826

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	06/26/2015

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