Provider Demographics
NPI:1720124290
Name:STEINMARK, ANDREW P (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:P
Last Name:STEINMARK
Suffix:
Gender:M
Credentials:PSYD
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 2572
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01004-2572
Mailing Address - Country:US
Mailing Address - Phone:413-241-7376
Mailing Address - Fax:
Practice Address - Street 1:195 RUSSELL ST
Practice Address - Street 2:SUITE B12
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9515
Practice Address - Country:US
Practice Address - Phone:413-241-7376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA09083103TH0004X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
001443901Medicare PIN