Provider Demographics
NPI:1003861725
Name:NOBILE, JOHN J (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:NOBILE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:131 W 35TH ST FL 7
Mailing Address - Street 2:FLOOR 7
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2111
Mailing Address - Country:US
Mailing Address - Phone:212-475-8066
Mailing Address - Fax:212-475-4175
Practice Address - Street 1:131 W 35TH ST FL 7
Practice Address - Street 2:FLOOR 7
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2111
Practice Address - Country:US
Practice Address - Phone:212-475-8066
Practice Address - Fax:212-475-4175
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2016-09-19
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Provider Licenses
StateLicense IDTaxonomies
NY155591207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00931159Medicaid
NYDO0835OtherOXFORD ID #
NY132789080OtherTAX IDENTIFICATION #
NY0858495OtherAETNA HMO ID #
NY0149041OtherGHI PPO
NY060012676OtherRR MEDICARE ID #
NYNJ5591OtherATLANTIS HEALTH PLAN
NY01HCQVOtherGHI/MEDICARE
NYA400057743Medicaid
NY41D363OtherEMPIRE BCBS
NY4238591OtherAETNA PPO ID #
NYCF7168OtherRR MEDICARE GROUP #
NYA400057743Medicaid
NYNJ5591OtherATLANTIS HEALTH PLAN
NY060012676OtherRR MEDICARE ID #
NYG400000055Medicare PIN