Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 270408 | NY |
NPI | 1023285368 |
---|---|
Provider Name | Dr. Kenan Walter Davis Stern |
First Address | Irvington, NY 10533-2302 |
Second Address | Bronx, NY 10467 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2008 |
Last Update Date | 16/08/2013 |