Elyse K Persico, D.V.M.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

014074 Issued in NY

Practice address

132 Jericho Tpke
Mineola, NY 11501-1856

Phone

(516) 873-9207

Fax

(516) 873-1221

NPI assigned

Jun 30, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1780035717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 JERICHO TPKE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115011856",
            "telephone_number": "516-873-9207",
            "fax_number": "516-873-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 JERICHO TPKE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115011856",
            "telephone_number": "516-873-9207",
            "fax_number": "516-873-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSICO",
        "first_name": "ELYSE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.V.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "014074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Perretta, LCSW-R, MASTER CASAC
• Elena Perrier, PT
• Alicia Kavita Persaud
• Lisa N Persaud, M.D.
• Melissa Persaud
• Michael Petelis, DO
• Valerie N Comissiong Peterkin, M.D.
• Barbara Peters, M.S.
• Nancy Peterson, NP
• Christopher Petillo

• Student in an Organized Health Care Education/Training Program in Mineola, NY
• Providers in Mineola, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.