Provider Demographics
NPI:1992840771
Name:SOBEL ORTHOTICS AND SHOES INC
Entity Type:Organization
Organization Name:SOBEL ORTHOTICS AND SHOES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBEL
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED PEDORTHIST
Authorized Official - Phone:845-255-9471
Mailing Address - Street 1:40 SUNSET RIDGE RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-1036
Mailing Address - Country:US
Mailing Address - Phone:845-255-5717
Mailing Address - Fax:845-255-5711
Practice Address - Street 1:40 SUNSET RIDGE RD
Practice Address - Street 2:SUITE 240
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1036
Practice Address - Country:US
Practice Address - Phone:845-255-5717
Practice Address - Fax:845-255-5711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6030450001Medicare NSC