Provider Demographics
NPI:1730258419
Name:MASTER, STEVEN B (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:B
Last Name:MASTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 E LANCASTER AVE
Mailing Address - Street 2:STE 1B
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312
Mailing Address - Country:US
Mailing Address - Phone:610-648-0555
Mailing Address - Fax:610-648-0555
Practice Address - Street 1:620 E LANCASTER AVE
Practice Address - Street 2:STE 1B
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312
Practice Address - Country:US
Practice Address - Phone:610-648-0555
Practice Address - Fax:610-648-0555
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005399L103TC0700X
NJS102536103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
R07472Medicare UPIN
MA590311Medicare ID - Type Unspecified