MEDICARE: DR. STEPHEN GERSTMAN D.D.S.

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	1223G0001X	General Practice Dentistry	23990	NY

General Provider Information

NPI Number	:	1326047978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN GERSTMAN D.D.S.

Provider Business Mailing Address
First Line	:	245 N BROADWAY
Second Line	:	SUITE 108
City	:	SLEEPY HOLLOW
State	:	NY
Zip	:	10591-2657
Country	:	US
Telephone Number	:	914-631-5217
Fax Number	:	914-332-4461

Provider Business Practice Location Address
First Line	:	245 N BROADWAY
Second Line	:	SUITE 108
City	:	SLEEPY HOLLOW
State	:	NY
Zip	:	10591-2657
Country	:	US
Telephone Number	:	914-631-5217
Fax Number	:	914-332-4461

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

Provider Enumeration Date	:	07/16/2005
Last Update Date	:	10/03/2007

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