Provider Demographics
NPI:1689613036
Name:STEVEN LEVENBERG, M.D., P.C.
Entity Type:Organization
Organization Name:STEVEN LEVENBERG, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-393-4656
Mailing Address - Street 1:667 CHAMBERS ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08611-3701
Mailing Address - Country:US
Mailing Address - Phone:609-393-4656
Mailing Address - Fax:609-393-4388
Practice Address - Street 1:667 CHAMBERS ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08611-3701
Practice Address - Country:US
Practice Address - Phone:609-393-4656
Practice Address - Fax:609-393-4388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA040306207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2361302Medicaid
0713313001OtherAMERIHEALTH GROUP PROVIDE
NJLE058107Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL PROVI
0713313001OtherAMERIHEALTH GROUP PROVIDE