Provider Demographics
NPI:1659249365
Name:PERSAUD, VISHWANAUTH (MPH,PHARMD CANDIDATE)
Entity type:Individual
Prefix:
First Name:VISHWANAUTH
Middle Name:
Last Name:PERSAUD
Suffix:
Gender:M
Credentials:MPH,PHARMD CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 E 243RD ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470-1069
Mailing Address - Country:US
Mailing Address - Phone:917-669-0748
Mailing Address - Fax:
Practice Address - Street 1:3 TIMES SQ
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-6564
Practice Address - Country:US
Practice Address - Phone:646-981-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-24
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104673I390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program