Organization
SANDRA BOLTAX-STERN, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA P BOLTAX-STERN M.D. (PRESIDENT)
(203) 387-3403
Entity
Organization
Contact information
Practice address
78 ANSONIA ROAD, WOODBRIDGE, CT 06525
(203) 387-3403
(203) 387-9125
Mailing address
78 ANSONIA ROAD, WOODBRIDGE, CT 06525
(203) 387-3403
(203) 387-9125
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
000011608
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001116086
—
CT
Enumeration date
05/30/2012
Last updated
05/30/2012
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