Individual provider · NPI-1

Devicka Persaud, DO

Family Medicine · South Richmond Hill, NY

NPI number1801965371
StatusActive
Last updated in NPPESNov 21, 2012

Details

NPI
1801965371
Entity type
Individual (NPI-1)
Name
Devicka Persaud
Credential
DO
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 7, 2006
Last updated
Nov 21, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine198493NYYes

Practice location

11512 Liberty Ave
South Richmond Hill, NY 11419-1902

Phone 718-641-3389

Mailing address

11512 Liberty Ave
South Richmond Hill, NY 11419-1902

Phone 718-641-3389

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