Provider Demographics
NPI:1861735284
Name:SOBOL, ELAIN (MD,)
Entity type:Individual
Prefix:DR
First Name:ELAIN
Middle Name:
Last Name:SOBOL
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 1:44 STRATHMORE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1036
Mailing Address - Country:US
Mailing Address - Phone:516-487-2514
Mailing Address - Fax:
Practice Address - Street 1:44 STRATHMORE RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-1036
Practice Address - Country:US
Practice Address - Phone:516-487-2514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128885208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice