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General NPI Number Information
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NPI Number | 1245813625
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Entity Type | Individual
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Provider Name | ROGER ELLIOT STERN MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2021
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 8268 164TH ST
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City | JAMAICA
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State | NY
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Zip | 11432-1104
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Country | US
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Telephone | 718-883-4583
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 KINGS WAY LN
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City | TARPON SPRINGS
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State | FL
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Zip | 34688-7653
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Country | US
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Telephone | 727-238-9573
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME168964
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME168964
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License Number State | FL
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