Provider Demographics
NPI:1528066693
Name:SHTERNFELD, ILONA SLUSKER (MD)
Entity type:Individual
Prefix:
First Name:ILONA
Middle Name:SLUSKER
Last Name:SHTERNFELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ILONA
Other - Middle Name:SLUSKER
Other - Last Name:SHTERNFELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2800 TAMARACK AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-5539
Mailing Address - Country:US
Mailing Address - Phone:860-648-0638
Mailing Address - Fax:860-648-0870
Practice Address - Street 1:2800 TAMARACK AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-5539
Practice Address - Country:US
Practice Address - Phone:860-648-0638
Practice Address - Fax:860-648-0870
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041170207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H17117Medicare UPIN