Provider Demographics
NPI:1841370673
Name:FEINSTEIN, STEVEN (EDO LIC PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:FEINSTEIN
Suffix:
Gender:M
Credentials:EDO LIC PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 MOUNTAINVIEW RD
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041
Mailing Address - Country:US
Mailing Address - Phone:973-467-5826
Mailing Address - Fax:973-467-5826
Practice Address - Street 1:1180 RT 22 WEST
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092
Practice Address - Country:US
Practice Address - Phone:973-818-3384
Practice Address - Fax:973-467-5828
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3177103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7218907Medicaid
NJ836336017Medicare ID - Type Unspecified