Healthcare Provider Details

I. General information

NPI: 1770405490
Provider Name (Legal Business Name): JONAH STEINBERG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 SAN PEDRO DR NE STE F10
ALBUQUERQUE NM
87110-4158
US

IV. Provider business mailing address

2315 SAN PEDRO DR NE STE F10
ALBUQUERQUE NM
87110-4158
US

V. Phone/Fax

Practice location:
  • Phone: 505-218-6542
  • Fax: 404-400-5003
Mailing address:
  • Phone: 505-218-6542
  • Fax: 404-400-5003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: