Provider Demographics
NPI:1770926115
Name:PERSAUD, SANDRA ELIZABETH (NP)
Entity type:Individual
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First Name:SANDRA
Middle Name:ELIZABETH
Last Name:PERSAUD
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Gender:F
Credentials:NP
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Mailing Address - Street 1:760 BROADWAY WOODHULL MEDICAL & MENTAL HEALTH CENTER
Mailing Address - Street 2:ATTN: HESHAM SHAABAN-DEPARTMENT OF PEDIATRICS ROOM 2B-3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:718-963-8214
Mailing Address - Fax:718-630-3122
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:WOODHULL MEDICAL & MENTAL HEALTH CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-963-8000
Practice Address - Fax:718-630-3122
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2014-10-31
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Provider Licenses
StateLicense IDTaxonomies
NYF337862-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily