MEDICARE: DR. ELIZABETH BENNET STERN 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	2084P0800X	Psychiatry Physician	35-062848	OH

General Provider Information

NPI Number	:	1700959533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH BENNET STERN M.D.

Provider Business Mailing Address
First Line	:	2460 FAIRMOUNT BLVD
Second Line	:	SUITE 210
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44106-3171
Country	:	US
Telephone Number	:	216-229-0550
Fax Number	:	216-229-0552

Provider Business Practice Location Address
First Line	:	2460 FAIRMOUNT BLVD
Second Line	:	SUITE 210
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44106-3171
Country	:	US
Telephone Number	:	216-229-0550
Fax Number	:	216-229-0552

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

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/08/2007

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