MEDICARE: BRENDA POMARANTZ STERN BRENDA STERN, LCSW

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	172V00000X	Community Health Worker	PO18449-1	NY

General Provider Information

NPI Number	:	1407189970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA POMARANTZ STERN BRENDA STERN, LCSW

Provider Business Mailing Address
First Line	:	73 QUARRY LN
Second Line	:
City	:	BEDFORD
State	:	NY
Zip	:	10506-1539
Country	:	US
Telephone Number	:	914-234-6376
Fax Number	:

Provider Business Practice Location Address
First Line	:	73 QUARRY LN
Second Line	:
City	:	BEDFORD
State	:	NY
Zip	:	10506-1539
Country	:	US
Telephone Number	:	914-234-6376
Fax Number	:

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

Provider Enumeration Date	:	09/15/2009
Last Update Date	:	09/15/2009

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