MEDICARE: DR. DANIEL E STERN D.P.M.

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	213E00000X	Podiatrist	N004302	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	198451P	OTHER	NY	HIP
2	2496	OTHER	NE	VYTRA
3	PO4302-9	OTHER	NY	WORKER'S COMPENSATION
4	AJ45251	OTHER	NY	MDNY
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	1400082	OTHER	NY	GHI
7	CS593	OTHER	NY	OXFORD
8	AETNA	OTHER	NY	4207335
9	DSOP240S10	OTHER	NY	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1639170889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL E STERN D.P.M.

Provider Business Mailing Address
First Line	:	100 MIDDLE COUNTRY RD
Second Line	:
City	:	CORAM
State	:	NY
Zip	:	11727-4412
Country	:	US
Telephone Number	:	631-696-9636
Fax Number	:	631-696-9635

Provider Business Practice Location Address
First Line	:	100 MIDDLE COUNTRY RD
Second Line	:
City	:	CORAM
State	:	NY
Zip	:	11727-4412
Country	:	US
Telephone Number	:	631-696-9636
Fax Number	:	631-696-9635

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/09/2007

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Directions to “ DR. DANIEL E STERN D.P.M.” Practice Location

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