Provider Demographics
NPI:1982769832
Name:STERN, ELAINE (LAC)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:STERN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 E 28TH ST RM 706
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-7937
Mailing Address - Country:US
Mailing Address - Phone:212-685-7179
Mailing Address - Fax:212-685-7179
Practice Address - Street 1:37 E 28TH ST RM 706
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-7937
Practice Address - Country:US
Practice Address - Phone:212-685-7179
Practice Address - Fax:212-685-7179
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist