Provider Demographics
NPI:1497718514
Name:GHABRIAL, SOBHY LABIB (MD)
Entity Type:Individual
Prefix:DR
First Name:SOBHY
Middle Name:LABIB
Last Name:GHABRIAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-3112
Mailing Address - Country:US
Mailing Address - Phone:860-646-3586
Mailing Address - Fax:860-646-7793
Practice Address - Street 1:153 MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-3112
Practice Address - Country:US
Practice Address - Phone:860-646-3586
Practice Address - Fax:860-646-7793
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT14809208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT024809OtherCONNECTICARE
CTHAP280OtherOXFORD HEALTH PLAN
CT83175OtherAETNA
CT010014809CT01OtherANTHEM BLUE CROSS BLUE SH
CT0R0751OtherHEALTHNET
CT1014809OtherCIGNA HEALTH PLAN
CT00114809700OtherBLUE CARE FAMILY PLAN