Provider Demographics
NPI:1053353532
Name:STERNBACH, MARNA RENA (MD)
Entity type:Individual
Prefix:
First Name:MARNA
Middle Name:RENA
Last Name:STERNBACH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1500 MARKET ST
Mailing Address - Street 2:24TH FLOOR WEST TOWER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2100
Mailing Address - Country:US
Mailing Address - Phone:215-255-3529
Mailing Address - Fax:215-832-2213
Practice Address - Street 1:1700 N BROAD ST, 2ND FLOOR
Practice Address - Street 2:TEMPLE UNIVERSITY - TUTTLEMAN COUNSELING SERVICES
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19121-3429
Practice Address - Country:US
Practice Address - Phone:215-204-7276
Practice Address - Fax:215-204-5419
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD026343E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000883320Medicaid
PAB41049Medicare UPIN
PA193979Medicare ID - Type Unspecified