Basic Information
| Provider Information | |||||||||
| NPI: | 1821149329 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STERN | ||||||||
| FirstName: | CHRISTINE | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.P.M. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 MIDDLE COUNTRY RD | ||||||||
| Address2: | |||||||||
| City: | CORAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117274412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316969636 | ||||||||
| FaxNumber: | 6316969635 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 MIDDLE COUNTRY RD | ||||||||
| Address2: | |||||||||
| City: | CORAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117274412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316969636 | ||||||||
| FaxNumber: | 6316969635 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2007 | ||||||||
| LastUpdateDate: | 04/15/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0131X | N004301 | NY | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot Surgery |
ID Information
| ID | Type | State | Issuer | Description | 13-3487494 | 01 | NY | MAGNACARE | OTHER | 198508P | 01 | NY | HIP | OTHER | P04461 | 01 | NY | BLUE CROSS & BLUE SHIELD | OTHER | 2132775 | 01 | NY | VYTRA HEALTH PLAN | OTHER | 4231526 | 01 | NY | AETNA | OTHER | AJ45250 | 01 | NY | MDNY | OTHER | PO4301-9 | 01 | NY | WORKER'S COMPENSATION | OTHER | 13-3487494 | 01 | NY | ISLAND GROUP | OTHER | 13-3487494 | 01 | NY | THE EMPIRE PLAN | OTHER | CS594 | 01 | NY | OXFORD | OTHER | 01072068 | 05 | NY | MEDICAID | 1400081 | 01 | NY | GHI | OTHER | 13-3487494 | 01 | NY | UNITED HEALTH CARE | OTHER | 480015215 | 01 | NY | RAIL ROAD MEDICARE | OTHER |