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General NPI Number Information
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NPI Number | 1114201340
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Entity Type | Organization
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Legal Business Name | MEDICAL OFFICE OF ANAND R PERSAUD MD PC
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 17325 JAMAICA AVE
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City | JAMAICA
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State | NY
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Zip | 11432-5523
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Country | US
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Telephone | 718-657-4000
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Fax | 718-657-6000
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Provider Business Mailing Address
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Address Line | 17325 JAMAICA AVE
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City | JAMAICA
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State | NY
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Zip | 11432-5523
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Country | US
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Telephone | 718-657-4000
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Fax | 718-657-6000
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANAND R PERSAUD
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Credential | MD
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Telephone | 516-623-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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