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General NPI Number Information
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NPI Number | 1649853243
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Entity Type | Individual
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Provider Name | BETHANY MARIE SOBBA
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Gender | Female
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Dates
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Enumeration Date | 04/30/2021
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 333 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2497
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Country | US
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Telephone | 888-369-2427
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Fax |
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Provider Business Mailing Address
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Address Line | 1325 ANNUNCIATION ST APT 412
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City | NEW ORLEANS
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State | LA
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Zip | 70130-4073
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Country | US
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Telephone |
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | MT233431
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License Number State | PA
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