Provider Demographics
NPI:1336246008
Name:STERN, STEPHEN L (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:L
Last Name:STERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S BEDFORD RD STE 214
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3454
Mailing Address - Country:US
Mailing Address - Phone:914-357-4067
Mailing Address - Fax:844-867-7220
Practice Address - Street 1:101 S BEDFORD RD STE 214
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3454
Practice Address - Country:US
Practice Address - Phone:914-357-4067
Practice Address - Fax:844-867-7220
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK94682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX043097701Medicaid
TXST084590JMedicare ID - Type Unspecified