Provider Demographics
NPI:1588777551
Name:STERNTHAL, HYMAN SOLOMON (LICENSEDPSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:HYMAN
Middle Name:SOLOMON
Last Name:STERNTHAL
Suffix:
Gender:M
Credentials:LICENSEDPSYCHOLOGIST
Other - Prefix:DR
Other - First Name:HYMAN
Other - Middle Name:SOLOMON
Other - Last Name:STERNTHAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICENSED PSYCHOLOGIS
Mailing Address - Street 1:245 ROCKMOORE CT
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-2935
Mailing Address - Country:US
Mailing Address - Phone:386-736-8997
Mailing Address - Fax:386-738-4351
Practice Address - Street 1:245 ROCKMOORE CT
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-2935
Practice Address - Country:US
Practice Address - Phone:386-736-8997
Practice Address - Fax:386-738-4351
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY2931103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73380Medicare UPIN