Provider Demographics
NPI:1033432224
Name:PERSAUD, BARBARA S (COTA/L,MS)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:S
Last Name:PERSAUD
Suffix:
Gender:F
Credentials:COTA/L,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 FULTON AVE
Mailing Address - Street 2:536
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4102
Mailing Address - Country:US
Mailing Address - Phone:347-596-2968
Mailing Address - Fax:
Practice Address - Street 1:3175 E TREMONT AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5700
Practice Address - Country:US
Practice Address - Phone:718-770-7686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003351173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine