Provider Demographics
NPI:1881747657
Name:STERN, LEON (MD)
Entity type:Individual
Prefix:
First Name:LEON
Middle Name:
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 1:11846 BAYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6204
Mailing Address - Country:US
Mailing Address - Phone:646-420-3680
Mailing Address - Fax:
Practice Address - Street 1:11846 BAYFIELD DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-6204
Practice Address - Country:US
Practice Address - Phone:646-420-3680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1429442084P0800X
FLME1649372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00509619Medicaid
B13563Medicare UPIN
NY00509619Medicaid