SANDIE JEAN DERIVAL

NEW HAVEN, CT
NPI1508266842
Former NameSANDIE JEAN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: CT  005821)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: CT  5821)
Enumeration Date2014-08-22
Last Update Date2018-06-27
Business Address
SANDIE JEAN DERIVAL APRN
20 YORK STREET, CB-2041
NEW HAVEN, CT 06510
Phone number: 203-688-4748
Mailing Address
SANDIE JEAN DERIVAL APRN
20 YORK STREET, CB-2041
NEW HAVEN, CT 06510-3220
Phone number: 203-688-4748