Provider Demographics
NPI:1275295115
Name:SOBIN, JAMIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:SOBIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 BEECH ST APT 33
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11509-1630
Mailing Address - Country:US
Mailing Address - Phone:516-318-9950
Mailing Address - Fax:
Practice Address - Street 1:1233 BEECH ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC BEACH
Practice Address - State:NY
Practice Address - Zip Code:11509-1600
Practice Address - Country:US
Practice Address - Phone:516-318-9950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025871225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist