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General NPI Number Information
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NPI Number | 1265460810
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Entity Type | Individual
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Provider Name | KERSTIN M SOBUS MD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 07/10/2018
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Provider Practice Location Address
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Address Line | 516 CAREW ST
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City | SPRINGFIELD
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State | MA
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Zip | 01104
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Country | US
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Telephone | 413-787-2051
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Fax | 413-787-2054
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Provider Business Mailing Address
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Address Line | 516 CAREW ST
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City | SPRINGFIELD
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State | MA
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Zip | 01104-2330
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Country | US
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Telephone | 413-787-2051
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Fax | 413-787-2054
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0010X
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Taxonomy Name | Pediatric Rehabilitation Medicine Physician
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License Number | 01061959
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 275036
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License Number State | MA
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