MEDICARE: ILONA SLUSKER SHTERNFELD M.D.

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	207W00000X	Ophthalmology Physician	041170	CT

General Provider Information

NPI Number	:	1528066693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ILONA SLUSKER SHTERNFELD M.D.

Provider Business Mailing Address
First Line	:	2800 TAMARACK AVE
Second Line	:	SUITE 102
City	:	SOUTH WINDSOR
State	:	CT
Zip	:	06074-5539
Country	:	US
Telephone Number	:	860-648-0638
Fax Number	:	860-648-0870

Provider Business Practice Location Address
First Line	:	2800 TAMARACK AVE
Second Line	:	SUITE 102
City	:	SOUTH WINDSOR
State	:	CT
Zip	:	06074-5539
Country	:	US
Telephone Number	:	860-648-0638
Fax Number	:	860-648-0870

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/11/2007

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