Provider Demographics
NPI:1497721229
Name:STERN, ANDREA ELLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:ELLEN
Last Name:STERN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:45 MERRIMACK ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1729
Mailing Address - Country:US
Mailing Address - Phone:978-459-2306
Mailing Address - Fax:978-453-9394
Practice Address - Street 1:45 MERRIMACK ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1729
Practice Address - Country:US
Practice Address - Phone:978-459-2306
Practice Address - Fax:978-453-9394
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA442522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB11692OtherBCBS MA
MAM18559OtherBLUE CROSS OF MA
MA713898OtherTUFTS
MA043071259OtherFALLON
MA343102OtherTUFTS
MA710249OtherTUFTS
MA1307606Medicaid
MA1300491Medicaid
MA1307614Medicaid
MA1307592Medicaid
MA724838OtherTUFTS HEALTH PLAN
MA701784OtherTUFTS
MAM18559OtherBLUE CROSS
MA1300491Medicaid