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General NPI Number Information
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NPI Number | 1801293121
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Entity Type | Individual
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Provider Name | JENNIFER SOBOL PA
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Gender | Female
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Dates
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Enumeration Date | 12/02/2014
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Last Update Date | 05/03/2019
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Provider Practice Location Address
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Address Line | 90 SOUTHSIDE AVE SUITE 350
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City | ASHEVILLE
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State | NC
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Zip | 28801-4160
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Country | US
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Telephone | 828-277-4810
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Fax |
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Provider Business Mailing Address
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Address Line | 404 CREEK CROSSING BLVD
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City | HAINESPORT
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State | NJ
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Zip | 08036-2768
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Country | US
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Telephone | 609-845-3988
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Fax | 609-288-6078
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 017426-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00332100
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-05817
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License Number State | NC
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