MEDICARE: MARNA RENA STERNBACH 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	207Q00000X	Family Medicine Physician	MD026343E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053353532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARNA RENA STERNBACH MD

Provider Business Mailing Address
First Line	:	1500 MARKET ST
Second Line	:	24TH FLOOR WEST TOWER
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-2100
Country	:	US
Telephone Number	:	215-255-3529
Fax Number	:	215-832-2213

Provider Business Practice Location Address
First Line	:	1700 N BROAD ST, 2ND FLOOR
Second Line	:	TEMPLE UNIVERSITY - TUTTLEMAN COUNSELING SERVICES
City	:	PHILADELPHIA
State	:	PA
Zip	:	19121-3429
Country	:	US
Telephone Number	:	215-204-7276
Fax Number	:	215-204-5419

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

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	12/07/2017

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