Provider Demographics
NPI:1679799878
Name:STERNBERG, RICHARD IRA (PHD, DABFE, DACFE)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:IRA
Last Name:STERNBERG
Suffix:
Gender:M
Credentials:PHD, DABFE, DACFE
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:914-472-2914
Mailing Address - Fax:914-472-2914
Practice Address - Street 1:22 FIFTH STREET
Practice Address - Street 2:THE PENTHOUSE
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5030
Practice Address - Country:US
Practice Address - Phone:203-359-4777
Practice Address - Fax:914-472-2914
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT754103T00000X
NJ1631103TF0200X
21212173000000X
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Not Answered173000000XOther Service ProvidersLegal Medicine
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT754OtherLICENSE
NJ1631OtherLICENSE
21212OtherFORENSIC EXAMINER
CT754OtherLICENSE
NJ1631OtherLICENSE