MEDICARE: ALYSON JILL STERN OTR/L

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	225X00000X	Occupational Therapist	OC013348	PA

General Provider Information

NPI Number	:	1336553155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSON JILL STERN OTR/L

Provider Business Mailing Address
First Line	:	6462 LAWNTON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-2524
Country	:	US
Telephone Number	:	215-901-8007
Fax Number	:

Provider Business Practice Location Address
First Line	:	6462 LAWNTON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-2524
Country	:	US
Telephone Number	:	215-901-8007
Fax Number	:

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

Provider Enumeration Date	:	06/19/2014
Last Update Date	:	06/19/2014

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