Provider Demographics
NPI:1902825185
Name:STERLIN, MYRIAM (MD)
Entity Type:Individual
Prefix:
First Name:MYRIAM
Middle Name:
Last Name:STERLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 EDGEWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901
Mailing Address - Country:US
Mailing Address - Phone:973-395-1550
Mailing Address - Fax:973-395-1556
Practice Address - Street 1:60 EVERGREEN PLACE
Practice Address - Street 2:SUITE 400
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018
Practice Address - Country:US
Practice Address - Phone:973-395-1550
Practice Address - Fax:973-395-1556
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214510207R00000X
NY214540207RI0200X
NJ25MA06625800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0010391Medicaid
NJ91002925400OtherAMERICHOICE
NJ085718TM8Medicare PIN
NJ91002925400OtherAMERICHOICE