Provider Demographics
NPI:1578812814
Name:STEINBERG, BENJAMIN S (PSYD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:S
Last Name:STEINBERG
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 MANCHESTER AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-1367
Mailing Address - Country:US
Mailing Address - Phone:732-800-7676
Mailing Address - Fax:732-800-7673
Practice Address - Street 1:34 MANCHESTER AVE STE 205
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-1367
Practice Address - Country:US
Practice Address - Phone:732-800-7676
Practice Address - Fax:732-800-7673
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-31
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00560200103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0541095Medicaid