MEDICARE: DR. RICHARD E STERN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XX0801X	Orthopaedic Trauma Physician	10418	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	104108	OTHER	NY	NYS LIC

General Provider Information

NPI Number	:	1023343464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD E STERN MD

Provider Business Mailing Address
First Line	:	1562 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-4004
Country	:	US
Telephone Number	:	212-861-9800
Fax Number	:	212-861-5276

Provider Business Practice Location Address
First Line	:	1562 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-4004
Country	:	US
Telephone Number	:	212-861-9800
Fax Number	:	212-861-5276

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2009
Last Update Date	:	10/02/2009

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