Provider Demographics
NPI:1710161153
Name:STERN, DANA (OD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:STERN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GARET PL
Mailing Address - Street 2:20 SOMETHING VISION
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-5421
Mailing Address - Country:US
Mailing Address - Phone:631-462-8562
Mailing Address - Fax:
Practice Address - Street 1:393 TYLER PL
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-1928
Practice Address - Country:US
Practice Address - Phone:516-996-6033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT-006108152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist