Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | X003954-1 | NY |
NPI | 1053411959 |
---|---|
Provider Name | Dr. Lawrence Gary Stern |
First Address | Mount Kisco, NY 10549-2855 |
Second Address | Mount Kisco, NY 10549-2855 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 22/05/2020 |