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Individual

JERZY P. SOBOTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
40 WRIGHT ST, DEPARTMENT OF PATHOLOGY, PALMER, MA 01069-1138
(413) 283-7651
(413) 284-5339
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
80133
MA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
80133
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3198723
MA
Enumeration date
10/27/2005
Last updated
11/04/2010
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