Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 230268 | NY |
NPI | 1013028687 |
---|---|
Provider Name | Dr. Andrea Nandini Persaud |
First Address | New York, NY 10041-0004 |
Second Address | New York, NY 10128-4007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 23/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I28274 | (02) | NY |