Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 25MA10257400 | NJ |
N | 111NI0900X | Internist | 25MA10257400 | NJ |
N | 207R00000X | Internist | 290843 | NY |
N | 111NI0900X | Internist | 290843 | NY |
Y | 207R00000X | Internist | 65003 | CT |
Y | 111NI0900X | Internist | 65003 | CT |
N | 207RA0401X | Internist - Addiction Medicine | ME133449 | FL |
NPI | 1083979066 |
---|---|
Provider Name | Jeffrey Stern |
First Address | Aventura, FL 33180-1455 |
Second Address | Stamford, CT 06905-5023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2012 |
Last Update Date | 23/03/2020 |