Provider Demographics
NPI:1568845642
Name:STERNBERG, VIVIAN TOBY (MA)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:TOBY
Last Name:STERNBERG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 HEATHCOTE RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-7106
Mailing Address - Country:US
Mailing Address - Phone:914-980-3824
Mailing Address - Fax:
Practice Address - Street 1:308 HEATHCOTE RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-7106
Practice Address - Country:US
Practice Address - Phone:914-980-3824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1596107174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist