KRISTAL SHIVANA PERSAUD


Address: 111 East 210th Street, Montefiore Medical Center, Bronx, NY 10467-2490
Phone: 7189204321

KRISTAL SHIVANA PERSAUD (NPI# 1679725626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679725626
Entity Type Individual
Full Name KRISTAL SHIVANA PERSAUD
Credential RPA-C
Practice Address 111 East 210th Street
Montefiore Medical Center
Bronx
NY 10467-2490
Mailing Address 1131 Waring Ave
Bronx
NY 10469-5439
Practice Telephone 7189204321
Mailing Telephone 6462450064
Enumeration Date 2008-10-21
Last Update Date 2008-10-21
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
23 012865 NY Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 111 EAST 210TH STREET
MONTEFIORE MEDICAL CENTER
City BRONX
State NY
Zip Code 10467-2490

Providers in the same location

NPI Name Taxonomy Address Enumeration
1235124355 Steven R Cohen Dermatology 111 East 210th Street, Division of Dermatology, Bronx, NY 10467-2490 2005-09-14
1760095780 Swapnil Singh Student in an Organized Health Care Education/Training Program 111 East 210th Street, Bronx, NY 10467 2020-08-28
1770105728 Lamiaa Abdallah Student in an Organized Health Care Education/Training Program 111 East 210th Street, Bronx, NY 10467 2020-05-13
1225666993 Rimon Golovey Student in an Organized Health Care Education/Training Program 111 East 210th Street, Bronx, NY 10467 2020-03-30
1205463213 Mina Mikhael Student in an Organized Health Care Education/Training Program 111 East 210th Street, Bronx, NY 10467 2020-03-27
1831725845 Laura F Rosado Albacarys Student in an Organized Health Care Education/Training Program 111 East 210th Street, Bronx, NY 10467 2020-03-21
1659924306 Osama Mohammad Salen Aldahamsheh Student in an Organized Health Care Education/Training Program 111 East 210th Street, Bronx, NY 10467 2019-07-22
1538711981 Eleni Drakou Student in an Organized Health Care Education/Training Program 111 East 210th Street, Bronx, NY 10467 2019-07-15
1790341790 Ezequiel Wendichansky Student in an Organized Health Care Education/Training Program 111 East 210th Street, Bronx, NY 10467 2019-05-15
1821556184 Elliot Saleh Student in an Organized Health Care Education/Training Program 111 East 210th Street, Bronx, NY 10467 2019-03-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215535505 Maxwell Ennist Massage Therapist 210 Bedford Park Blvd, Bronx, NY 10467 2020-10-09
1144854431 Ny Metro Dental, PC Dentist 55 Mosholu Parkway North, Bronx, NY 10467 2020-02-26
1386277960 Rhonda Ellen Nayberg Occupational Therapist Montefiore Medical Center Occupational Therapy Dept, 111 E 210 Street Ground Floor Blue Zone, Bronx, NY 10467 2020-02-21
1013568153 Jaime Luis Betancourt Nurse Practitioner Sickle Cell Clinic, 3400 Bainbridge Avenue, Bronx, NY 10467 2019-09-20
1023662616 Bronx Jewish Community Council Home Attendant Services Home Health 2930 Wallace Ave., Bronx, NY 10467 2019-07-31
1831755321 Felix Medrano Taxi 3106 Webster Ave, Bronx, NY 10467 2019-05-10
1700363108 Danaies Guzman Occupational Therapist 2410 Barker Avenue Apt 11a, Bronx, New York, NY 10467 2018-07-27
1538672175 Carolina Duque-toro Speech-Language Pathologist 4251, 341 E 207th St, Bronx, NY 10467 2017-11-06
1255853727 Jessica Perkiss Social Worker 750 Tilden St., Astor Services for Children and Families, Bronx, NY 10467 2017-07-17
1386166221 Erica Santos Licensed Practical Nurse 3273 Parkside Place, Apt 5g, Bronx, NY 10467 2017-07-12
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1447815949 Shadman Emrose Noshin Physician Assistant 2843 Dudley Ave Fl 2, Bronx, NY 10461-5609 2019-05-09
1275024952 Barbara Hoffman Physician Assistant 1017 Burke Ave, Bronx, NY 10469-3803 2018-05-29
1154791473 Edelmys Suncar Physician Assistant 1150 Webster Ave, Bronx, NY 10456-5205 2015-09-29
1083096697 Victoria Owusuaa Physician Assistant 2334 Tiebout Ave, Apt # 4e, Bronx, NY 10458-7310 2015-06-19
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1235532078 Ethan Searles Physician Assistant 91 Poplar Ave, Bronx, NY 10465-3943 2014-10-08
1053713164 Pranvera Dervishi Physician Assistant 1334 Astor Ave, Pvh 2nd Floor, Bronx, NY 10469-5832 2014-09-19
1588934814 Melinda Jimenez Physician Assistant 2306 Walton Ave, Bronx, NY 10468-7102 2012-01-03
1194094300 Ayisha Munawar Physician Assistant 285 E 171st St, Bronx, NY 10457-8939 2011-12-16
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Competitor

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City BRONX
Zip Code 10467

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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