Provider Demographics
NPI:1275283962
Name:STEINEMANN, BECKER T
Entity Type:Individual
Prefix:
First Name:BECKER
Middle Name:T
Last Name:STEINEMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 BLUE POINTE LN APT 302
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-2258
Mailing Address - Country:US
Mailing Address - Phone:303-241-0133
Mailing Address - Fax:
Practice Address - Street 1:6934 WILLIAMS RD STE 200
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-3080
Practice Address - Country:US
Practice Address - Phone:716-297-8260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine