Provider Demographics
NPI:1487762654
Name:STERNBERG, LAWRENCE BERNARD (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:BERNARD
Last Name:STERNBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 HIGHLAND GRN
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-8803
Mailing Address - Country:US
Mailing Address - Phone:585-924-7093
Mailing Address - Fax:
Practice Address - Street 1:15 HIGHLAND GRN
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-8803
Practice Address - Country:US
Practice Address - Phone:585-924-7093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104388207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB72100Medicare UPIN