Provider Demographics
NPI:1710632138
Name:SOBEL, NATHANIEL MATTHEW
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:MATTHEW
Last Name:SOBEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 TIKVAH WAY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-3607
Mailing Address - Country:US
Mailing Address - Phone:908-723-1799
Mailing Address - Fax:
Practice Address - Street 1:809 N WOOD AVE # 7036
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:908-723-1799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06667700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker