Provider Demographics
NPI:1326012972
Name:GINSBERG, STEVEN ERIK
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:ERIK
Last Name:GINSBERG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 BAY 32 ST
Mailing Address - Street 2:
Mailing Address - City:BAYSWATER
Mailing Address - State:NY
Mailing Address - Zip Code:11691
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2391 ARTHUR AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-8185
Practice Address - Country:US
Practice Address - Phone:718-365-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N005906-2173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02387153Medicaid
U90674Medicare UPIN
NY02387153Medicaid
P00089268Medicare PIN