Provider Demographics
NPI:1497268221
Name:STERNBERG, CHANE
Entity Type:Individual
Prefix:
First Name:CHANE
Middle Name:
Last Name:STERNBERG
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 1:12 LAURA PL
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-3837
Mailing Address - Country:US
Mailing Address - Phone:845-729-1806
Mailing Address - Fax:
Practice Address - Street 1:295 W ROUTE 59
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5449
Practice Address - Country:US
Practice Address - Phone:845-533-3227
Practice Address - Fax:845-746-9761
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker