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Organization
WILLIAMSON MEDICAL PLLC
Active
Organization
WILLIAMSON MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISHNA V PERSAUD MD (OWNER MD)
(315) 589-4641
Entity
Organization
Contact information
Practice address
4418 RIDGE RD E, WILLAMSON MEDICAL PLLC, WILLIAMSON, NY 14589
(315) 589-4641
(315) 589-9585
Mailing address
4418 RIDGE RD E, WILLAMSON MEDICAL PLLC, WILLIAMSON, NY 14589
(315) 589-4641
(315) 589-9585
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02329519
—
NY
01
—
G0180451260
BLUE
—
Enumeration date
08/23/2006
Last updated
01/24/2008
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