Sandie Jean Derival, APRN | |
20 York Street, Cb-2041, New Haven, CT 06510 | |
(203) 688-4748 | |
(203) 688-4740 |
Full Name | Sandie Jean Derival |
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Gender | Female |
Speciality | Nurse Practitioner |
Location | 20 York Street, Cb-2041, New Haven, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508266842 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 5821 (Connecticut) | Secondary |
363L00000X | Nurse Practitioner | 005821 (Connecticut) | Primary |
Entity Name | Yale University |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205822236 PECOS PAC ID: 9436061736 Enrollment ID: O20031105000015 |
Entity Name | Northeast Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043278351 PECOS PAC ID: 1254233836 Enrollment ID: O20040123000522 |
Mailing Address | Practice Location Address |
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Sandie Jean Derival, APRN 20 York Street, Cb-2041, New Haven, CT 06510-3220 Ph: (203) 688-4748 | Sandie Jean Derival, APRN 20 York Street, Cb-2041, New Haven, CT 06510 Ph: (203) 688-4748 |
Audrey P Senior, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 20 York St, New Haven, CT 06510 Phone: 203-688-5860 Fax: 203-688-7533 | |
Ashley Antonucci, DNP- FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 Long Wharf Dr, New Haven, CT 06511 Phone: 203-688-8800 | |
Bailey Daum, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 40 Trumbull St, New Haven, CT 06510 Phone: 646-270-4857 | |
Mrs. Lisa Jane Warren, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 20 York St, New Haven, CT 06510 Phone: 203-688-7952 | |
Dana Marie Stournaras, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 501 Crescent St, New Haven, CT 06515 Phone: 033-927-2782 | |
Mrs. Rocca L Perruccio, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 428 Columbus Ave, New Haven, CT 06519 Phone: 203-503-3000 Fax: 203-503-3224 | |
Dr. Shelley Yerger Hawkins, DSN, APRN-BC, FAANP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 Church St S, #271, New Haven, CT 06519 Phone: 205-999-9029 Fax: 203-785-6455 |