Provider Demographics
NPI:1932220688
Name:STERN, JUDITH R (PSYD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:R
Last Name:STERN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JUDITH
Other - Middle Name:R
Other - Last Name:STERN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:255 S 17TH ST
Mailing Address - Street 2:SUITE 2601
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-6231
Mailing Address - Country:US
Mailing Address - Phone:215-842-9987
Mailing Address - Fax:
Practice Address - Street 1:255 S 17TH ST
Practice Address - Street 2:SUITE 2601
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6231
Practice Address - Country:US
Practice Address - Phone:215-842-9987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist