Healthcare Provider Details

I. General information

NPI: 1659397651
Provider Name (Legal Business Name): RONALD A STERN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 05/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 THIELLS MT IVY ROAD SUITE 4
POMONA NY
10970-3020
US

IV. Provider business mailing address

155 CRYSTAL RUN RD
MIDDLETOWN NY
10941-4028
US

V. Phone/Fax

Practice location:
  • Phone: 845-354-7957
  • Fax: 845-354-8034
Mailing address:
  • Phone: 845-703-6999
  • Fax: 845-703-6297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number157281
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: