Individual
DR. ARETHA NANDA PERSAUD-MANCUSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
150 BROADHOLLOW RD STE 311, MELVILLE, NY 11747-4901
(631) 470-7915
(631) 470-7922
Mailing address
1010 NORTHERN BLVD STE 328, GREAT NECK, NY 11021-5329
(516) 233-2484
(516) 304-5850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
228552
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116432
GHI
NY
01
—
1396247
AETNA
NY
01
—
2387689
UNITED HEALTHCARE
NY
01
—
349448P
HIP
—
01
—
5763A1
BLUE CROSS AND BLUE SHIELD
NY
01
—
P3715262
OXFORD
NY
01
—
PA8552
ATLANTIS HEALTHCARE
NY
Enumeration date
08/21/2006
Last updated
10/23/2024
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