MEDICARE: DR. RYAN SOBEL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	MA08428100	NJ
2	207V00000X	Obstetrics & Gynecology Physician	222228	NY
3	207V00000X	Obstetrics & Gynecology Physician	MD435149	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962477174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN SOBEL MD

Provider Business Mailing Address
First Line	:	833 CHESTNUT ST
Second Line	:	CONCOURSE LEVEL
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4414
Country	:	US
Telephone Number	:	215-955-5000
Fax Number	:	215-503-6702

Provider Business Practice Location Address
First Line	:	833 CHESTNUT ST
Second Line	:	1ST FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4414
Country	:	US
Telephone Number	:	215-955-6776
Fax Number	:	215-955-4020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	06/11/2020

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Directions to “ DR. RYAN SOBEL MD” Practice Location

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