Provider Demographics
NPI:1821310541
Name:STERN CHIROPRACTIC INTEGRATIVE WELLNESS, P.C.
Entity Type:Organization
Organization Name:STERN CHIROPRACTIC INTEGRATIVE WELLNESS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:914-218-6424
Mailing Address - Street 1:121 SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2855
Mailing Address - Country:US
Mailing Address - Phone:914-218-6424
Mailing Address - Fax:
Practice Address - Street 1:121 SMITH AVE
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2855
Practice Address - Country:US
Practice Address - Phone:914-218-6424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX-003954-1111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX-22151Medicare PIN