Provider Demographics
NPI:1598952160
Name:STERN, JAY IVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:IVAN
Last Name:STERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5501 45TH AVENUE
Mailing Address - Street 2:APT. #501
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781
Mailing Address - Country:US
Mailing Address - Phone:410-608-1618
Mailing Address - Fax:561-766-1210
Practice Address - Street 1:5804 BALTIMORE AVENUE
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20781
Practice Address - Country:US
Practice Address - Phone:301-927-7800
Practice Address - Fax:301-927-0375
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0034206207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME11554OtherMEDICAL LICENSE
FLME11554OtherMEDICAL LICENSE