MRS. SANDRA DENISE THEBAUD-YOUNG (NPI# 1114043064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114043064 |
| Entity Type | Individual |
| Full Name | MRS. SANDRA DENISE THEBAUD-YOUNG |
| Credential | APRN-BC |
| Practice Address |
254 Easton Avenue New Brunswick New Brunswick NJ 08901 |
| Mailing Address |
239 40th St Irvington Irvington NJ 07111-1100 |
| Practice Telephone | 9083921948 |
| Practice Fax Number | 9733372045 |
| Mailing Telephone | 9733715563 |
| Mailing Fax Number | 9733372045 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2009-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
26NJ00129300 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE | 112818VGD | 01 | |
| NJ | 0147320 | 05 |
| Street Address |
254 EASTON AVENUE NEW BRUNSWICK |
| City | NEW BRUNSWICK |
| State | NJ |
| Zip Code | 08901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487652988 | Michael Theodore Kicenuik | Obstetrics & Gynecology | 254 Easton Avenue, Women's Health -cares Building 3 Rd Floor, New Brunswick, NJ 08901 | 2005-07-08 |
| 1720453384 | Lehaz Mohammed Kaker | Hospitalist | 254 Easton Avenue, New Brunswick, NJ 08901 | 2015-12-08 |
| 1245604198 | Eliyahu Lustiger | Emergency Medicine | 254 Easton Avenue, Department of Emergency Services, New Brunswick, NJ 08901 | 2015-11-16 |
| 1982043949 | Yojna Singh | Internal Medicine | 254 Easton Avenue, Saint Peter's University Hospital, New Brunswick, NJ 08901 | 2013-06-22 |
| 1184912701 | Christina Tesoriero | Physician Assistant | 254 Easton Avenue, St. Peter's University Hospital, New Brunswick, NJ 08901 | 2011-07-17 |
| 1215245246 | Kerri D'onofrio | Nurse Practitioner | 254 Easton Avenue, New Brunswick, NJ 08901 | 2010-09-24 |
| 1326376781 | Bibina Varughese | Dietitian, Registered | 254 Easton Avenue, New Brunswick, NJ 08901-0591 | 2009-11-24 |
| 1407016157 | Adam Poller | Nurse Practitioner | 254 Easton Avenue, Saint Peter's University Hospital, New Brunswick, NJ 08901 | 2008-06-16 |
| 1124213152 | Patricia Klass | Physician Assistant | 254 Easton Avenue, St. Peters University Hospital, New Brunswick, NJ 08901 | 2007-09-12 |
| 1679664734 | Gichell Watson | Physician Assistant | 254 Easton Avenue, St Peters University Hospital, New Brunswick, NJ 08901 | 2006-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083242622 | Daniel Kareem Haddad | Student in an Organized Health Care Education/Training Program | 1 Robert Wood Johnson Place, Meb 422a, New Brunswick, NJ 08901 | 2020-03-30 |
| 1922636588 | Neil Anjan Basumallik | Student in an Organized Health Care Education/Training Program | Rutgers Rwjms, Department of Medicine, 125 Paterson Street. Cab 7300, New Brunswick, NJ 08901 | 2020-03-30 |
| 1922636406 | Naveena Lall | Student in an Organized Health Care Education/Training Program | Rutgers Robert Wood Johnson Internal Medicine Residency, 125 Paterson Street, New Brunswick, NJ 08901 | 2020-03-30 |
| 1801444047 | Swati Vijay Dhobale | Student in an Organized Health Care Education/Training Program | Saint Peter's University Hospital, 254 Easton Avenue, 4th Floor, Cares Room 4014, New Brunswick, NJ 08901 | 2019-08-30 |
| 1962974329 | Lauren Burgstresser | Nurse Practitioner | 181 Somerset Street, 3rd Floor, New Brunswick, NJ 08901 | 2018-12-26 |
| 1851874291 | Damon House Inc. | Substance Abuse Rehabilitation Facility | 105 Joyce Kilmer Ave, New Brunswick, NJ 08901 | 2018-09-12 |
| 1245718204 | Leah Dinardo | Psychologist | 61 Nichol Ave, New Brunswick, NJ 08901 | 2018-08-01 |
| 1730667130 | Keshav Bhandari | Student in an Organized Health Care Education/Training Program | Saint Peters University Hospital, 254 Easton Avenue, 4th Floor Cares, Rm 4014, New Brunswick, NJ 08901 | 2018-07-30 |
| 1942787486 | Mehak Bassi | Student in an Organized Health Care Education/Training Program | 4th Floor Cares, Rm 4014 240 Easton Avenue, New Brunswick, NJ 08901 | 2018-07-27 |
| 1063908754 | Oluwatoba Opeyemi Moninuola | Student in an Organized Health Care Education/Training Program | 4th Floor Cares, Rm 4014, 240 Easton Avenue, New Brunswick, NJ 08901 | 2018-07-05 |
| Find all providers in zip 08901 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982077699 | Zawadi Anglin | Nurse Practitioner | 247 George St, New Brunswick, NJ 08901-1313 | 2015-11-03 |
| 1225317373 | Vivian Owusu-mensah | Nurse Practitioner | 10 Plum Street 3rd Floor Breast Care Connection, Robert Wood Johnson University Hospital, New Brunswick, NJ 08901-2065 | 2011-08-08 |
| 1609026665 | Jacquelyn Plick | Nurse Practitioner | 125 Paterson St Ste 5100a, New Brunswick, NJ 08901 | 2008-09-26 |
| 1508083734 | Dorothy Neressa Pierce | Nurse Practitioner | 1robert Wood Johnson Place, New Brunswick, NJ 08903-2601 | 2007-04-19 |
| 1205933694 | Karen Therese Dalonzo | Nurse Practitioner | 11 Nicoll Street, New Brunswick, NJ 08901-2889 | 2006-09-20 |
| 1588769517 | Dorothy M Kozlowski | Nurse Practitioner | 11 Suydam St, Willets Health Center Rutgers University, New Brunswick, NJ 08901 | 2006-09-14 |
| 1982707576 | Diane Jo Heimlich | Nurse Practitioner | 61 Dudley Rd, New Brunswick, NJ 08901-8520 | 2006-09-07 |
| 1992807226 | Gail P Daly | Nurse Practitioner | Willets Health Center, 11 Suydam St, New Brunswick, NJ 08901-2995 | 2006-09-05 |
| 1033112859 | Kathy O Covert | Nurse Practitioner | 254 Easton Ave, New Brunswick, NJ 08901-1766 | 2005-05-24 |
| 1942849757 | Rosalind Julius-mickel | Nurse Practitioner | 125 Paterson St, New Brunswick, NJ 08901-1962 | 2019-12-26 |
| Find all providers in NEW BRUNSWICK | ||||
| City | NEW BRUNSWICK |
| Zip Code | 08901 |
Please comment or provide details below to improve the information on MRS. SANDRA DENISE THEBAUD-YOUNG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.