| Persaud Medical, Pllc | |
|
150 Broadhollow Rd Suite 311 Melville NY 11747-4905 | |
| (631) 470-7915 | |
| (631) 470-7922 |
| Full Name | Persaud Medical, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 150 Broadhollow Rd, Melville, New York |
| Authorized Official Name and Position | Aretha Persaud (OWNER) |
| Authorized Official Contact | 6314707915 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Persaud Medical, Pllc 150 Broadhollow Rd Suite 311 Melville NY 11747-4905 Ph: (631) 470-7915 | Persaud Medical, Pllc 150 Broadhollow Rd Suite 311 Melville NY 11747-4905 Ph: (631) 470-7915 |
| NPI Number | 1942329107 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 12/28/2010 |
| Medicare PECOS PAC ID | 6608970397 |
|---|---|
| Medicare Enrollment ID | O20070406000294 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942329107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | 228552 (New York) | Primary |
| Provider Name | Aretha N Persaud-mancusi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497861843 PECOS PAC ID: 2961499652 Enrollment ID: I20040426001601 |
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