Provider Demographics
NPI:1285629246
Name:STERLING EMERGENCY PHYSICIANS OF WEST BOCA PA
Entity Type:Organization
Organization Name:STERLING EMERGENCY PHYSICIANS OF WEST BOCA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DRESNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-514-1494
Mailing Address - Street 1:PO BOX 534213
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-4213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21644 STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1842
Practice Address - Country:US
Practice Address - Phone:561-488-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDC1358OtherRR MCR GROUP
FL74776OtherBCBS GROUP
FL=========OtherCHAMPUS GROUP
FLK6609Medicare PIN
FL=========OtherCHAMPUS GROUP
FL74776OtherBCBS GROUP