Thebaud-Young, Sandra Denise

Thebaud-Young, Sandra Denise is an individual health care provider with primary practice located at 254 Easton Avenue New Brunswick, New Brunswick NJ 08901. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Thebaud-Young, Sandra Denise can be contacted via phone (908) 392-1948.

Contact Information

Primary practice address
254 Easton Avenue New Brunswick New Brunswick NJ 08901
Phone: (908) 392-1948
Fax: (973) 337-2045
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 26NJ00129300 New Jersey

Profile Details

NPI number 1114043064
LBN Legal business name Thebaud-Young, Sandra Denise
Credentials APRN-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2007
Last updated Oct 26th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114043064 NPPES
New Jersey MEDICAID 0147320
New Jersey Other 112818VGD

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