MEDICARE: JEFFREY H STERN, MD, PHD, LLC

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	174400000X	Specialist	184437	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	:	1831399773
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFREY H STERN, MD, PHD, LLC

Provider Business Mailing Address
First Line	:	1365 WASHINGTON AVE
Second Line	:	SUITE 101
City	:	ALBANY
State	:	NY
Zip	:	12206-1068
Country	:	US
Telephone Number	:	518-437-1111
Fax Number	:	518-435-1114

Provider Business Practice Location Address
First Line	:	1365 WASHINGTON AVE
Second Line	:	SUITE 101
City	:	ALBANY
State	:	NY
Zip	:	12206-1099
Country	:	US
Telephone Number	:	518-437-1111
Fax Number	:	518-435-1114

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	TRUDY ARENA
Credential	:
Telephone Number	:	518-437-1111

Provider Enumeration Date	:	07/19/2007
Last Update Date	:	07/20/2007

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