Provider Demographics
NPI:1598950149
Name:DAVID SOBEL LLC
Entity Type:Organization
Organization Name:DAVID SOBEL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:SOBEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:203-271-0053
Mailing Address - Street 1:5 CURRIER WAY
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-1428
Mailing Address - Country:US
Mailing Address - Phone:203-271-0053
Mailing Address - Fax:860-567-1775
Practice Address - Street 1:33 VILLAGE GREEN DR
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-3419
Practice Address - Country:US
Practice Address - Phone:860-567-4565
Practice Address - Fax:860-567-1775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2016152W00000X, 152WC0802X, 152WP0200X, 152WS0006X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Single Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTCO3321OtherMEDICARE GROUP #
CTCT2016OtherEYE MED VISION CARE
CTDE2000OtherRAILROAD MEDICARE GROUP#
CT16909OtherSPECTERA/UHS VISION
CT0297031OtherCIGNA
CT4063624Medicaid
CT090002016CT18OtherANTHEM BC & BS
CT1084515OtherAETNA
CT2V5458OtherHEALTHNET
CT713538OtherCONNECTICARE, INC.