Provider Demographics
NPI:1649293994
Name:STERN, PERRI (RPA-C)
Entity type:Individual
Prefix:MRS
First Name:PERRI
Middle Name:
Last Name:STERN
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 REDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1030
Mailing Address - Country:US
Mailing Address - Phone:516-295-1424
Mailing Address - Fax:917-771-0591
Practice Address - Street 1:512 REDWOOD DR
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1030
Practice Address - Country:US
Practice Address - Phone:516-295-1424
Practice Address - Fax:917-771-0591
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007965363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6383WZMedicare ID - Type Unspecified
Q18962Medicare UPIN