Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 298986 | NY |
NPI | 1023493020 |
---|---|
Provider Name | Amanda Persaud |
First Address | Great Neck, NY 11021-5207 |
Second Address | Great Neck, NY 11021-5207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2015 |
Last Update Date | 27/05/2020 |