Provider Demographics
NPI:1780692707
Name:SOBEL, DAVID J (OD LLC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:SOBEL
Suffix:
Gender:M
Credentials:OD LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CURRIER WAY
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-1428
Mailing Address - Country:US
Mailing Address - Phone:203-271-0053
Mailing Address - Fax:860-567-1775
Practice Address - Street 1:33 VILLAGE GREEN DR
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-3419
Practice Address - Country:US
Practice Address - Phone:860-567-4565
Practice Address - Fax:860-567-1775
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT2016152W00000X, 152WC0802X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT713538OtherCONNECTICARE
CT090002016CT18OtherANTHEM BCBS
CT4063624Medicaid
CT090002016CT18OtherANTHEM BCBS
T23234Medicare UPIN