Healthcare Provider Details

I. General information

NPI: 1265937619
Provider Name (Legal Business Name): SARAH BETH YAVELBERG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 12/09/2021
Certification Date: 12/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ROBERT WOOD JOHNSON PL
NEW BRUNSWICK NJ
08901-1928
US

IV. Provider business mailing address

125 PATERSON STREET MEB 308
NEW BRUNSWICK NJ
08901-0019
US

V. Phone/Fax

Practice location:
  • Phone: 973-747-2341
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA11100100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: