Provider Demographics
NPI:1710008107
Name:STERN, DONNEL BERNARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONNEL
Middle Name:BERNARD
Last Name:STERN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 E 82ND ST
Mailing Address - Street 2:1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0344
Mailing Address - Country:US
Mailing Address - Phone:212-879-5286
Mailing Address - Fax:
Practice Address - Street 1:24 E 82ND ST
Practice Address - Street 2:1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0344
Practice Address - Country:US
Practice Address - Phone:212-879-5286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005794103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical