Healthcare Provider Details

I. General information

NPI: 1154436756
Provider Name (Legal Business Name): CAROLYN RUTH STERN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLYN STERN SPANJER MD

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/05/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 GENESEE ST WALK IN CARE CENTER
ROCHESTER NY
14611-3201
US

IV. Provider business mailing address

58 EASTLAND AVE
ROCHESTER NY
14618-1030
US

V. Phone/Fax

Practice location:
  • Phone: 585-368-3877
  • Fax:
Mailing address:
  • Phone: 585-271-7004
  • Fax: 585-271-3826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number209791
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number209791
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: