Individual
ASHLEY VENITA PERSAUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12515 135TH AVE, SOUTH OZONE PARK, NY 11420-3207
(347) 207-2423
Mailing address
12515 135TH AVE, SOUTH OZONE PARK, NY 11420-3207
(347) 207-2423
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
024112
NY
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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