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General NPI Number Information
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NPI Number | 1649353962
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Entity Type | Organization
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Legal Business Name | ANDREA N PERSAUD MD PC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 36 E 36TH ST PH A SUITE 202
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City | NEW YORK
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State | NY
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Zip | 10016-3453
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Country | US
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Telephone | 212-683-6073
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 LEXINGTON AVE # 9K
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City | NEW YORK
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State | NY
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Zip | 10029-7349
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Country | US
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Telephone | 917-734-2326
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ANDREA NANDINI PERSAUD
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Credential | MD
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Telephone | 917-734-2326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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