Provider Demographics
NPI:1811384688
Name:SOBEL, ABE
Entity Type:Individual
Prefix:
First Name:ABE
Middle Name:
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 1:920 E 17TH ST
Mailing Address - Street 2:#120
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-3751
Mailing Address - Country:US
Mailing Address - Phone:718-253-7140
Mailing Address - Fax:
Practice Address - Street 1:920 E 17TH ST
Practice Address - Street 2:#120
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-3751
Practice Address - Country:US
Practice Address - Phone:718-253-7140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2132187103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool