Healthcare Provider Details

I. General information

NPI: 1083251375
Provider Name (Legal Business Name): JOSHUA PERSAUD MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2019
Last Update Date: 09/06/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 WASHINGTON ROAD
WEEHAWKEN NJ
07086
US

IV. Provider business mailing address

59 NORTHWOOD DR
FRANKLIN LAKES NJ
07417-2292
US

V. Phone/Fax

Practice location:
  • Phone: 201-794-6008
  • Fax: 516-517-9515
Mailing address:
  • Phone:
  • Fax: 516-517-9515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA PERSAUD
Title or Position: MD
Credential:
Phone: 561-389-0118