Provider Demographics
NPI:1073783544
Name:STERN, BEZALEL
Entity Type:Individual
Prefix:MR
First Name:BEZALEL
Middle Name:
Last Name:STERN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ROBERT PITT DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-3373
Mailing Address - Country:US
Mailing Address - Phone:845-517-2652
Mailing Address - Fax:845-517-2654
Practice Address - Street 1:23 ROBERT PITT DR
Practice Address - Street 2:SUITE 110
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3373
Practice Address - Country:US
Practice Address - Phone:845-517-2652
Practice Address - Fax:845-517-2654
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022816-1225100000X
NJ40QA01354600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q12V51Medicare PIN