Jennifer Lynn Sobotka, RN,BSN,CLC

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

618197 Issued in NY

Practice address

750 E Adams St
Syracuse, NY 13210-2306

Phone

(315) 464-6323

NPI assigned

Aug 18, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Collins Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503014400000",
    "number": "1750807087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8270 COTTONWOOD CT",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130906814",
            "telephone_number": "315-572-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBOTKA",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "RN,BSN,CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-18",
        "last_updated": "2017-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "618197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "COLLINS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tina M Snyder, LCSW
• Ryan Bonaventure Soares, MBBS
• Sobhy Electrodiagnostic and Pain Medicine P.C.
• Saad George Sobhy, MD
• Erin E Sobotka, M.S.
• Jessica Sobotka, LPN
• Maureen Soderberg, M.D.
• Michael K Soeder, M.D.
• Nelson Sofoluke, MD
• Wuraola Sofowote

• Registered Nurse in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.