Provider Demographics
NPI:1801329719
Name:MARK SOBEL, M.D., P.C.
Entity type:Organization
Organization Name:MARK SOBEL, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-291-4085
Mailing Address - Street 1:25 FIRST AVENUE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716
Mailing Address - Country:US
Mailing Address - Phone:732-291-4085
Mailing Address - Fax:732-291-4086
Practice Address - Street 1:25 FIRST AVENUE
Practice Address - Street 2:SUITE 110
Practice Address - City:ATLANTIC HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07716
Practice Address - Country:US
Practice Address - Phone:732-291-4085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY177451-1332BC3200X, 332B00000X
NJMA063035332BC3200X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment