Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 43221 | NY |
NPI | 1154540821 |
---|---|
Provider Name | Dr. Steven M Stern |
First Address | Williamsville, NY 14221-1789 |
Second Address | Williamsville, NY 14221-1789 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 08/07/2007 |