Healthcare Provider Details

I. General information

NPI: 1063944171
Provider Name (Legal Business Name): NATASHA VERAMA PERSAUD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 08/18/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHILDREN'S HOSPITAL OF PHILADELPHIA 3401 CIVIC BLVD.
PHILADELPHIA PA
19104-3364
US

IV. Provider business mailing address

2929 ARCH ST FL 12
PHILADELPHIA PA
19104-2857
US

V. Phone/Fax

Practice location:
  • Phone: 215-901-6404
  • Fax:
Mailing address:
  • Phone: 215-901-6404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberMD488914
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: