Healthcare Provider Details

I. General information

NPI: 1598950149
Provider Name (Legal Business Name): DAVID SOBEL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 VILLAGE GREEN DR
LITCHFIELD CT
06759-3419
US

IV. Provider business mailing address

5 CURRIER WAY
CHESHIRE CT
06410-1428
US

V. Phone/Fax

Practice location:
  • Phone: 860-567-4565
  • Fax: 860-567-1775
Mailing address:
  • Phone: 203-271-0053
  • Fax: 860-567-1775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number2016
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number2016
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number2016
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number2016
License Number StateCT
# 5
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2016
License Number StateCT

VIII. Authorized Official

Name: DR. DAVID JAY SOBEL
Title or Position: OWNER
Credential: O.D.
Phone: 203-271-0053