Provider Demographics
NPI:1508805136
Name:STEENBERGEN, MARK ALAN (DO)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALAN
Last Name:STEENBERGEN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:29 FOX ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-4714
Mailing Address - Country:US
Mailing Address - Phone:845-483-0447
Mailing Address - Fax:845-483-0716
Practice Address - Street 1:29 FOX ST
Practice Address - Street 2:SUITE 200
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4714
Practice Address - Country:US
Practice Address - Phone:845-483-0447
Practice Address - Fax:845-483-0716
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY187298207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01513859Medicaid
NY01513859Medicaid
NYF56998Medicare UPIN