Provider Demographics
NPI:1316653736
Name:SOBEL, ESTHER (PA-C)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:SOBEL
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 NEILSON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5055
Mailing Address - Country:US
Mailing Address - Phone:718-306-2429
Mailing Address - Fax:
Practice Address - Street 1:1166 RIVER AVE STE 105
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5600
Practice Address - Country:US
Practice Address - Phone:732-200-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00919600363AM0700X
NY029651363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical