Individual
ADIENA PERSAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 GUSTAVE L LEVY PL FL 12, NEW YORK, NY 10029-6574
(212) 241-6500
Mailing address
13215 105TH ST, OZONE PARK, NY 11417-2612
(646) 491-2209
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
025759
NY
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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