Provider Demographics
NPI:1205270436
Name:PERSAD, KAMLEISH A (DO)
Entity type:Individual
Prefix:
First Name:KAMLEISH
Middle Name:A
Last Name:PERSAD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:155 MEDICAL CENTER WAY
Mailing Address - Street 2:2ND FL
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2306
Mailing Address - Country:US
Mailing Address - Phone:609-365-3100
Mailing Address - Fax:609-365-3165
Practice Address - Street 1:155 MEDICAL CENTER WAY
Practice Address - Street 2:2ND FL
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2306
Practice Address - Country:US
Practice Address - Phone:609-365-3100
Practice Address - Fax:609-365-3165
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB10495000207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease