Provider Demographics
NPI:1417198532
Name:SOBEL, BILLI (RN, LMT)
Entity Type:Individual
Prefix:
First Name:BILLI
Middle Name:
Last Name:SOBEL
Suffix:
Gender:F
Credentials:RN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2526 GENESEE ST FL 2
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5814
Mailing Address - Country:US
Mailing Address - Phone:315-732-0032
Mailing Address - Fax:
Practice Address - Street 1:2709 GENESEE ST FL 2
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-6222
Practice Address - Country:US
Practice Address - Phone:315-732-0032
Practice Address - Fax:315-797-1193
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-19
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022311225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist