MEDICARE: STEVEN ELBOGEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	44SL07429400	NJ
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1407664980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN ELBOGEN

Provider Business Mailing Address
First Line	:	PO BOX 2036
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-8036
Country	:	US
Telephone Number	:	732-367-4700
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 AIRPORT RD STE 7G
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-5968
Country	:	US
Telephone Number	:	732-276-1510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2024
Last Update Date	:	03/05/2026

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Directions to “ STEVEN ELBOGEN ” Practice Location

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