Provider Demographics
NPI:1235491937
Name:STERN, KATERYNA
Entity Type:Individual
Prefix:
First Name:KATERYNA
Middle Name:
Last Name:STERN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 CONEY ISLAND AVE APT 3A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6612
Mailing Address - Country:US
Mailing Address - Phone:347-575-7997
Mailing Address - Fax:
Practice Address - Street 1:3250 CONEY ISLAND AVE APT 3A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6612
Practice Address - Country:US
Practice Address - Phone:347-575-7997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-09
Last Update Date:2012-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1295738OtherPUBLIC SCHOOL TEACHER CERTIFICATE