Provider Demographics
NPI:1134715634
Name:VANSTEENBURG, CATHERINE A
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:VANSTEENBURG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 744
Mailing Address - Street 2:
Mailing Address - City:COBLESKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12043-0744
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:102 MEADOW LANE
Practice Address - Street 2:APARTMENT 1
Practice Address - City:COBLESKILL
Practice Address - State:NY
Practice Address - Zip Code:12043
Practice Address - Country:US
Practice Address - Phone:518-231-9781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05Medicaid