Provider Demographics
NPI:1578793477
Name:EDWARD SZTEINBAUM, MD, LLC
Entity Type:Organization
Organization Name:EDWARD SZTEINBAUM, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SZTEINBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-921-3666
Mailing Address - Street 1:117 MASON DR
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-1021
Mailing Address - Country:US
Mailing Address - Phone:609-921-3666
Mailing Address - Fax:609-921-3660
Practice Address - Street 1:330 N HARRISON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-3524
Practice Address - Country:US
Practice Address - Phone:609-921-3666
Practice Address - Fax:609-921-3660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-26
Last Update Date:2009-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA5891000251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
002956Medicare UPIN