Provider Demographics
NPI:1912082579
Name:STERN-TORRES, CORI S (DC)
Entity Type:Individual
Prefix:
First Name:CORI
Middle Name:S
Last Name:STERN-TORRES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12215 25TH RD # B-3
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-1013
Mailing Address - Country:US
Mailing Address - Phone:718-358-1155
Mailing Address - Fax:718-358-9592
Practice Address - Street 1:122 15 25 RD #B-3
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11354-1234
Practice Address - Country:US
Practice Address - Phone:718-358-1155
Practice Address - Fax:718-358-9592
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX10050111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04587Medicare PIN