Provider Demographics
NPI:1427417971
Name:STEFAN A. PASTERNACK, M.D.
Entity Type:Organization
Organization Name:STEFAN A. PASTERNACK, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEFAN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:PASTERNACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-706-9584
Mailing Address - Street 1:950 PENINSULA CORPORATE CIRCLE
Mailing Address - Street 2:#2004
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1386
Mailing Address - Country:US
Mailing Address - Phone:561-706-9584
Mailing Address - Fax:561-495-0544
Practice Address - Street 1:950 PENINSULA CORP. CIRCLE
Practice Address - Street 2:#2004
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1386
Practice Address - Country:US
Practice Address - Phone:561-706-9584
Practice Address - Fax:561-495-0266
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEFAN A PASTERNACK, M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME814452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty