Individual
MRS. JENNIFER SHAKUNTALA PERSAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
27 VERONA PL, VALLEY STREAM, NY 11580-5421
(516) 728-3601
(516) 812-0071
Mailing address
27 VERONA PL, VALLEY STREAM, NY 11580-5421
(516) 728-3601
(516) 812-0071
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
513619
NY
363LP2300X
Primary Care Nurse Practitioner
Primary
513619
NY
Other
Enumeration date
12/24/2008
Last updated
12/24/2008
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