Provider Demographics
NPI:1437254463
Name:REICH-SOBEL, DEBRA GAIL (DO)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:GAIL
Last Name:REICH-SOBEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 N WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-4037
Mailing Address - Country:US
Mailing Address - Phone:908-486-7773
Mailing Address - Fax:908-925-4311
Practice Address - Street 1:809 N WOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4037
Practice Address - Country:US
Practice Address - Phone:908-486-7773
Practice Address - Fax:908-925-4311
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB05179300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE63884Medicare UPIN