Active NPI
Marc Bruce Sternberg, ED.D, FPPR, FSMI
- Clinical Psychologist
- Oakland Gardens, NY
National Provider Identifier
1881817351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 005795
- Practice address
- 21422 73Rd Ave
Oakland Gardens, NY 11364-2914 - Phone
- (718) 464-4444
- NPI assigned
- Apr 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 005795 | NY | Primary |
Addresses
Primary practice location
21422 73Rd Ave
Oakland Gardens, NY 11364-2914
Mailing address
8246 217TH St
Jamaica, NY 11427-1414
Phone (718) 479-4414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01619254 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005795 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881817351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8246 217TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114271414",
"telephone_number": "718-479-4414",
"fax_number": "718-479-9787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21422 73RD AVE",
"city": "OAKLAND GARDENS",
"state": "NY",
"postal_code": "113642914",
"telephone_number": "718-464-4444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STERNBERG",
"first_name": "MARC",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "ED.D, FPPR, FSMI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "005795",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01619254",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakland Gardens, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.