Provider Demographics
NPI:1962450742
Name:SOBEL, VERED (MD)
Entity Type:Individual
Prefix:
First Name:VERED
Middle Name:
Last Name:SOBEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4501
Mailing Address - Country:US
Mailing Address - Phone:802-773-2020
Mailing Address - Fax:206-666-4407
Practice Address - Street 1:65 ALLEN ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4501
Practice Address - Country:US
Practice Address - Phone:802-773-2020
Practice Address - Fax:206-666-4407
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420011634207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00402862OtherPALMETTO
MO207178914Medicaid
MOP00402862OtherPALMETTO
H13515Medicare UPIN