Healthcare Provider Details

I. General information

NPI: 1043250707
Provider Name (Legal Business Name): STEVEN M. BEENSTOCK D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RIVERFRONT PLZ STE 300
NEWARK NJ
07102-5412
US

IV. Provider business mailing address

PO BOX 40409
BELFAST ME
04915-1255
US

V. Phone/Fax

Practice location:
  • Phone: 201-273-7047
  • Fax: 855-998-4358
Mailing address:
  • Phone: 201-273-7047
  • Fax: 855-998-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB07314600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: