Provider Demographics
NPI:1215021241
Name:SOBEL, EDWARD C (DC)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:C
Last Name:SOBEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 YEW RD
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19012-1218
Mailing Address - Country:US
Mailing Address - Phone:215-576-0551
Mailing Address - Fax:215-663-9290
Practice Address - Street 1:135 YEW RD
Practice Address - Street 2:
Practice Address - City:CHELTENHAM
Practice Address - State:PA
Practice Address - Zip Code:19012-1218
Practice Address - Country:US
Practice Address - Phone:215-576-0551
Practice Address - Fax:215-663-9290
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003853L111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1453569Medicare UPIN
PA2139454000Medicare UPIN