Individual
KRISTAL SHIVANA PERSAUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
111 EAST 210TH STREET, MONTEFIORE MEDICAL CENTER, BRONX, NY 10467-2490
(718) 920-4321
Mailing address
1131 WARING AVE, BRONX, NY 10469-5439
(646) 245-0064
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
23 012865
NY
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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