Healthcare Provider Details

I. General information

NPI: 1417048786
Provider Name (Legal Business Name): HARVEY JAY STERN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GIVF 3015 WILLIAMS DR. #300
FAIRFAX VA
22031
US

IV. Provider business mailing address

GIVF PAYMENT/CORRESPONDENCE ADDRESS PO BOX 17016
BALTIMORE MD
21297-1016
US

V. Phone/Fax

Practice location:
  • Phone: 703-289-1977
  • Fax: 703-697-3977
Mailing address:
  • Phone: 703-289-1977
  • Fax: 703-698-3977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number0101044238
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: