Individual
CHARISSE PERSAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1256 E 103RD ST, BROOKLYN, NY 11236-4502
(718) 671-2100
Mailing address
1256 E 103RD ST, BROOKLYN, NY 11236-4502
(718) 671-2100
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
300513
NY
Other
Enumeration date
04/09/2010
Last updated
04/09/2010
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