Healthcare Provider Details

I. General information

NPI: 1922095298
Provider Name (Legal Business Name): ELLIOT B STERENFELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 07/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1671 CROOKED OAK DR
LANCASTER PA
17601-4207
US

IV. Provider business mailing address

1671 CROOKED OAK DR
LANCASTER PA
17601-4207
US

V. Phone/Fax

Practice location:
  • Phone: 717-569-5331
  • Fax: 717-569-4210
Mailing address:
  • Phone: 717-569-5331
  • Fax: 717-569-4210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD049136L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: