Provider Demographics
NPI:1992760268
Name:STERNBERG, RICHARD (CHIROPRACTOR)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:STERNBERG
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9785 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3319
Mailing Address - Country:US
Mailing Address - Phone:718-261-9100
Mailing Address - Fax:718-897-2916
Practice Address - Street 1:9785 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3319
Practice Address - Country:US
Practice Address - Phone:718-261-9100
Practice Address - Fax:718-897-2916
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008791174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV01485Medicare UPIN
NY0567ABMedicare PIN