Provider Demographics
NPI:1275502239
Name:SOBSEY, JOAN MELINDA (NP)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:MELINDA
Last Name:SOBSEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 LACONIA AVE
Mailing Address - Street 2:APT G
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-5260
Mailing Address - Country:US
Mailing Address - Phone:718-415-7700
Mailing Address - Fax:718-982-2966
Practice Address - Street 1:242 MASON AVE
Practice Address - Street 2:STATEN ISLAND UNIVERSITY HOSPITAL, ADOLESCENT PROGRAM
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306
Practice Address - Country:US
Practice Address - Phone:718-226-6294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332035363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily