Provider Demographics
NPI:1437160306
Name:SOBIN, BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:
Last Name:SOBIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4 FARM SPRINGS RD
Mailing Address - Street 2:PROHEALTH PHYSICIANS
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2573
Mailing Address - Country:US
Mailing Address - Phone:860-284-5200
Mailing Address - Fax:860-284-5333
Practice Address - Street 1:483 MIDDLE TPKE W
Practice Address - Street 2:#300
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-3863
Practice Address - Country:US
Practice Address - Phone:860-646-3814
Practice Address - Fax:860-649-5219
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT017195207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB83132Medicare UPIN