Provider Demographics
NPI:1043250707
Name:BEENSTOCK, STEVEN M (DO)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:BEENSTOCK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40409
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-1255
Mailing Address - Country:US
Mailing Address - Phone:201-273-7047
Mailing Address - Fax:855-998-4358
Practice Address - Street 1:1 RIVERFRONT PLZ STE 300
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-5412
Practice Address - Country:US
Practice Address - Phone:201-273-7047
Practice Address - Fax:855-998-4358
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07314600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0123029OtherGHI PPO
NJ1246768OtherAETNA HMO
NJ7920432OtherAETNA PPO
NJ2785652000OtherAMERIHEALTH
NJP00475866OtherRAILROAD MEDICARE
NJ3K3090OtherHEALTHNET
NJP3672900OtherOXFORD
NJ5772U1OtherEMPIRE BC/BS
NJ8824002Medicaid
NJ1246768OtherAETNA HMO
NJ053374CBCMedicare PIN