Provider Demographics
NPI:1659328946
Name:STEENBERG, LYNN B (PT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:B
Last Name:STEENBERG
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6319 FLY RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9357
Mailing Address - Country:US
Mailing Address - Phone:315-410-6200
Mailing Address - Fax:
Practice Address - Street 1:6319 FLY RD
Practice Address - Street 2:SUITE 3
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9357
Practice Address - Country:US
Practice Address - Phone:315-410-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005623-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY005623-1OtherPHYSICAL THERAPY LICENSE
NY000222-0OtherATHLETIC TRAINER CERT