Provider Demographics
NPI:1356466684
Name:STEINBERG, TRACY (CNS)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:
Last Name:STEINBERG
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 AURORA CT STE C318
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2541
Mailing Address - Country:US
Mailing Address - Phone:720-848-0840
Mailing Address - Fax:720-848-0841
Practice Address - Street 1:1635 AURORA COURT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045
Practice Address - Country:US
Practice Address - Phone:720-848-0840
Practice Address - Fax:720-848-0841
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO96-169261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
P96070Medicare UPIN