Healthcare Provider Details

I. General information

NPI: 1730995648
Provider Name (Legal Business Name): TZIPORAH STERN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 OCEAN PKWY APT 5J
BROOKLYN NY
11230-5122
US

IV. Provider business mailing address

1225 OCEAN PKWY APT 5J
BROOKLYN NY
11230-5122
US

V. Phone/Fax

Practice location:
  • Phone: 347-374-1598
  • Fax:
Mailing address:
  • Phone: 347-374-1598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: