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General NPI Number Information
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NPI Number | 1043474794
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Entity Type | Individual
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Provider Name | NADIA P PERSAUD RPA-C
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Gender | Female
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 150 55TH STREET RM 4823-4TH FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11220-2324
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Country | US
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Telephone | 718-630-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 150 55TH ST RM 4823- 4TH FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11220-2559
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Country | US
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Telephone | 718-630-7000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 007436-1
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License Number State | NY
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