Individual
SERGEI A SOBOLEVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
480 COURT ST STE 101, BROOKLYN, NY 11231-4091
(718) 393-5559
(718) 603-9469
Mailing address
40 E OAKDENE AVE UNIT A, PALISADES PARK, NJ 07650-1630
(646) 267-3432
(718) 603-9469
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
C1140
KY
2085R0202X
Diagnostic Radiology Physician
C1140
KY
2085R0204X
Vascular & Interventional Radiology Physician
Primary
220183
NY
2085R0204X
Vascular & Interventional Radiology Physician
C1140
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02800351
—
NY
05
—
300090853
—
IN
01
—
K0014786
MEDICARE
KY
Enumeration date
04/19/2006
Last updated
01/10/2025
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