Provider Demographics
NPI:1962912154
Name:SOBIN, YONATAN MOSHE (PSYD)
Entity type:Individual
Prefix:DR
First Name:YONATAN
Middle Name:MOSHE
Last Name:SOBIN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 LEXINGTON AVE RM 1000
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6586
Mailing Address - Country:US
Mailing Address - Phone:347-708-2920
Mailing Address - Fax:
Practice Address - Street 1:370 LEXINGTON AVE RM 1000
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:347-708-2920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-03
Last Update Date:2018-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022355103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical