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Individual

JON KOGOD STERNBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1839 FAIR AVE, HONESDALE, PA 18431-2121
(570) 251-6500
(570) 253-8174
Mailing address
1839 FAIR AVE, HONESDALE, PA 18431-2121
(570) 251-6500
(570) 253-8174

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1471641
NY
207Q00000X
Family Medicine Physician
Primary
MD025493E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000835304
PA
01
002313
FIRST PRIORITY HEALTH ID
05
00679718
NY
01
29942
GEISINGER HEALH PLAN ID
01
69A131
BLUE SHIELD ID NUMBER
NY
01
ST415829
BLUE SHIELD ID NUMBER
PA
Enumeration date
03/31/2006
Last updated
11/06/2009
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