Provider Demographics
NPI:1013006311
Name:STERN, LESLIE E (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:E
Last Name:STERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1030 PRESIDENT AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5923
Mailing Address - Country:US
Mailing Address - Phone:508-235-6395
Mailing Address - Fax:508-235-6473
Practice Address - Street 1:1030 PRESIDENT AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-235-6395
Practice Address - Fax:508-235-6473
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA38368207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA12006OtherHARVARD PILGRIM HEALTH
MA2034875Medicaid
MA733131OtherTUFTS
RI202086OtherRI BLUE CHIP
MA0013710OtherNEIGHBORHOOD HEALTH
RI4864-6OtherRI BLUE SHIELD
MA12006OtherHARVARD PILGRIM HEALTH