Provider Demographics
NPI:1750128641
Name:PERSAUD, DAHLIA (NP)
Entity type:Individual
Prefix:
First Name:DAHLIA
Middle Name:
Last Name:PERSAUD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 TANFORAN CT
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3521
Mailing Address - Country:US
Mailing Address - Phone:718-598-1588
Mailing Address - Fax:
Practice Address - Street 1:3840 QUAKERBRIDGE RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1003
Practice Address - Country:US
Practice Address - Phone:973-326-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15019700363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics