Provider Demographics
NPI:1811495344
Name:PASTERNAK, STEPHANIE SAUER (CD(DONA), CLC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:SAUER
Last Name:PASTERNAK
Suffix:
Gender:F
Credentials:CD(DONA), CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 BERKELEY DR
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-1224
Mailing Address - Country:US
Mailing Address - Phone:201-245-7614
Mailing Address - Fax:201-567-0258
Practice Address - Street 1:332 E RTE 4 LBBY
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5114
Practice Address - Country:US
Practice Address - Phone:201-245-7614
Practice Address - Fax:201-567-0258
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL12559374J00000X
MA258328174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty