Healthcare Provider Details

I. General information

NPI: 1730610387
Provider Name (Legal Business Name): ZACHARY S STEINBACH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 08/19/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 SILVER ST
MIDDLETOWN CT
06457-3946
US

IV. Provider business mailing address

16 COVENTRY ST
HARTFORD CT
06112-1524
US

V. Phone/Fax

Practice location:
  • Phone: 877-577-3233
  • Fax:
Mailing address:
  • Phone: 860-569-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number066730
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number066730
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: