Provider Demographics
NPI:1699294942
Name:TEITELBAUM, YEHUDIS SARA (NP)
Entity type:Individual
Prefix:MRS
First Name:YEHUDIS
Middle Name:SARA
Last Name:TEITELBAUM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 730
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-0730
Mailing Address - Country:US
Mailing Address - Phone:917-280-4559
Mailing Address - Fax:
Practice Address - Street 1:16 OVERHILL RD
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-2529
Practice Address - Country:US
Practice Address - Phone:917-280-4559
Practice Address - Fax:917-280-4559
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-18
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY644624163W00000X
NY351162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse