Individual
ALICIA KAVITA PERSAUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 MAIN STREET, MINEOLA, NY 11501
(516) 747-2644
Mailing address
110 MAIN STREET, MINEOLA, NY 11501
(516) 747-2644
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
006990
NY
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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