Individual provider Active NPI

Lalta Persaud - Jaikaran Bedessie

  • Licensed Practical Nurse
  • South Ozone Park, NY
National Provider Identifier
1508023904
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
251980-1 Issued in NY
Practice address
15047 129TH St
South Ozone Park, NY 11420-4246
Phone
(347) 239-0653
NPI assigned
May 22, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 251980-1 NY Primary

Addresses

Primary practice location

15047 129TH St
South Ozone Park, NY 11420-4246

Mailing address

15047 129TH St
South Ozone Park, NY 11420-4246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
251980-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1508023904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15047 129TH ST",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114204246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15047 129TH ST",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114204246",
            "telephone_number": "347-239-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDESSIE",
        "first_name": "LALTA",
        "middle_name": "PERSAUD - JAIKARAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "251980-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.