Jennifer Shakuntala Persad, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

513619 Issued in NY

Practice address

27 Verona PL
Valley Stream, NY 11580-5421

Phone

(516) 728-3601

Fax

(516) 812-0071

NPI assigned

Dec 24, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1230076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230076800000",
    "number": "1932345865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 VERONA PL",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805421",
            "telephone_number": "516-728-3601",
            "fax_number": "516-812-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 VERONA PL",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805421",
            "telephone_number": "516-728-3601",
            "fax_number": "516-812-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSAD",
        "first_name": "JENNIFER",
        "middle_name": "SHAKUNTALA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-24",
        "last_updated": "2008-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "513619",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "513619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Minera Devi Persaud
• Shane Anand Persaud, PHARMD
• Valerie R Persaud, DDS
• Personal Quality Care Manual PT
• Tulsa Peters, LMHC, LPC

• Primary Care Nurse Practitioner in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Primary Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.