Provider Demographics
NPI:1346281920
Name:STERNLIEB, JONATHAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:M
Last Name:STERNLIEB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 RYDAL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RYDAL
Mailing Address - State:PA
Mailing Address - Zip Code:19046-1711
Mailing Address - Country:US
Mailing Address - Phone:267-620-1100
Mailing Address - Fax:215-572-1279
Practice Address - Street 1:1095 RYDAL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RYDAL
Practice Address - State:PA
Practice Address - Zip Code:19046-1711
Practice Address - Country:US
Practice Address - Phone:267-620-1100
Practice Address - Fax:215-572-1279
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036106E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA231937219OtherMULITPLAN
PA4113671OtherAETNA
PA0419872000OtherKEYSTONE EAST
PA231937219OtherDEVON
PAP386844OtherOXFORD
PA14617OtherHEALTH PARTNERS
PW000597476OtherAMERIHEALTH
PA100006780OtherPALMETTO GBA
PW000597476OtherHIGHMARK BLUE SHIELD
PA000597476OtherPERSONAL CHOICE
PA1024677OtherKEYSTONE MERCY
PA231937219OtherFIRST HEALTH
PA0012281600003Medicaid
PW0301672008OtherCIGNA
PA231937219OtherTRICARE
PA597476Medicare ID - Type UnspecifiedMEDICARE