Basic Information
| Provider Information | |||||||||
| NPI: | 1811592900 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YOURMAN | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | RDN, CDCES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 102 11TH AVE | ||||||||
| Address2: | |||||||||
| City: | HAWTHORNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 075061111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2016967692 | ||||||||
| FaxNumber: | 2017911241 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 PROSPECT AVE FL WFAN3 | ||||||||
| Address2: | |||||||||
| City: | HACKENSACK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076011915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5519965329 | ||||||||
| FaxNumber: | 5519960115 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2020 | ||||||||
| LastUpdateDate: | 06/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | N | Dietary & Nutritional Service Providers | Dietitian, Registered | 2080P0206X | 86059594 | IL | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Gastroenterology | 133VN1004X | 86059594 | IL | Y | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Pediatric |
No ID Information.