=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205918059
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN GINSBERG MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/20/2006
-----------------------------------------------------
Last Update Date | 12/14/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 ROBERT WOOD JOHNSON PL
-----------------------------------------------------
City | NEW BRUNSWICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08901-1928
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-937-8841
-----------------------------------------------------
Fax | 732-418-8492
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 66 W GILBERT ST 2ND FLOOR
-----------------------------------------------------
City | TINTON FALLS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07701-4947
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-212-0051
-----------------------------------------------------
Fax | 732-212-0713
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 25MA05795500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------