Devicka Persaud Medical PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DEVICKA PERSAUD MEDICAL PC

Practice address

11512 Liberty Ave
South Richmond Hill, NY 11419-1902

Phone

(718) 641-3389

NPI assigned

Nov 7, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Devicka Devi Persaud, M.DNPI 1801965371

Title

Owner

Phone

(718) 641-3389

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Devicka Persaud, DO

  • Family Medicine Physician
  • South Richmond Hill, NY
  • NPI 1801965371
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354492800000",
    "number": "1407925977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11512 LIBERTY AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191902",
            "telephone_number": "718-641-3389",
            "fax_number": "718-879-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11512 LIBERTY AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191902",
            "telephone_number": "718-641-3389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVICKA PERSAUD MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2012-12-03",
        "status": "A",
        "authorized_official_last_name": "PERSAUD",
        "authorized_official_first_name": "DEVICKA",
        "authorized_official_middle_name": "DEVI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-641-3389",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meher P Daruwalla
• Sarah Lindsay Davison
• Shamilla Debideen
• Surijdei Amanda Decruiz, MD
• Julieta A Deguzman, MD
• DGN Family Medicine, PLLC,
• Bakthavatsalu Dhama, RPH
• Pallab Kumar Dhar
• Nicole Dicarlo, NP
• Danny Lee Donaldson, R.N.

• Family Medicine Physician in South Richmond Hill, NY
• Providers in South Richmond Hill, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.