Provider Demographics
NPI:1952402018
Name:STEINBERG, JAKOB (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAKOB
Middle Name:
Last Name:STEINBERG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W HANOVER AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-4221
Mailing Address - Country:US
Mailing Address - Phone:973-895-4799
Mailing Address - Fax:973-895-4796
Practice Address - Street 1:10 W HANOVER AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-4221
Practice Address - Country:US
Practice Address - Phone:973-895-4799
Practice Address - Fax:973-895-4796
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00260400103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJHE003399-P3QMedicare ID - Type Unspecified