MEDICARE: PNINA L STERN SLP

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	235Z00000X	Speech-Language Pathologist	023291-1	NY

General Provider Information

NPI Number	:	1063140689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PNINA L STERN SLP

Provider Business Mailing Address
First Line	:	13738 70TH AVE
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-1926
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	541 PASSAIC AVE
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07014-1211
Country	:	US
Telephone Number	:	973-778-6386
Fax Number	:

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

Provider Enumeration Date	:	08/11/2022
Last Update Date	:	08/11/2022

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Directions to “ PNINA L STERN SLP” Practice Location

Language	Start Address	Practice Location

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