1487792479 NPI number — MS. PAULA H SOBEL LCSW CLINICAL SOCIAL

Table of content: MS. PAULA H SOBEL LCSW CLINICAL SOCIAL (NPI 1487792479)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487792479 NPI number — MS. PAULA H SOBEL LCSW CLINICAL SOCIAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOBEL
Provider First Name:
PAULA
Provider Middle Name:
H
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW CLINICAL SOCIAL
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487792479
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
625 MAIN ST
Provider Second Line Business Mailing Address:
APT 1032 ROOSEVELT ISLAND
Provider Business Mailing Address City Name:
NY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-319-4351
Provider Business Mailing Address Fax Number:
212-848-6020

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
625 MAIN ST
Provider Second Line Business Practice Location Address:
APT 1032 ROOSEVELT ISLAND
Provider Business Practice Location Address City Name:
NY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-319-4351
Provider Business Practice Location Address Fax Number:
212-848-6020
Provider Enumeration Date:
02/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  SWR0199861 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 05036654 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 158583 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: N2R66 . This is a "EMPIRE BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2571390 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 088961 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7484572 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1057520 . This is a "BEACON" identifier . This identifiers is of the category "OTHER".




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