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Individual

DAVENDRA PERSAUD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
12 COLUMBUS AVE, VALHALLA, NY 10595-1702
(914) 358-1003
Mailing address
12 COLUMBUS AVE, VALHALLA, NY 10595-1702
(914) 358-1003

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
299986-1
NY

Other

Enumeration date
03/30/2011
Last updated
03/30/2011
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