Provider Demographics
NPI:1821075003
Name:STERN, SHARONE (DPM)
Entity Type:Individual
Prefix:
First Name:SHARONE
Middle Name:
Last Name:STERN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1144 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-5047
Mailing Address - Country:US
Mailing Address - Phone:516-942-0620
Mailing Address - Fax:516-942-0625
Practice Address - Street 1:175 JERICHO TPKE
Practice Address - Street 2:SUITE 300
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4532
Practice Address - Country:US
Practice Address - Phone:516-496-7676
Practice Address - Fax:516-942-0625
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005276213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP61732OtherNATIONAL GOVERMENT SERVICES, INC.
NY7395900001OtherPTAN
NYP61732OtherNATIONAL GOVERMENT SERVICES, INC.
NYU62081Medicare UPIN
NY02500JMedicare PIN