Individual
DEVICKA PERSAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
11512 LIBERTY AVE, SOUTH RICHMOND HILL, NY 11419-1902
(718) 641-3389
Mailing address
11512 LIBERTY AVE, SOUTH RICHMOND HILL, NY 11419-1902
(718) 641-3389
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
198493
NY
Other
Enumeration date
11/07/2006
Last updated
11/21/2012
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