Provider Demographics
NPI:1548515273
Name:PERSAUD, NEILSHA (LPN)
Entity type:Individual
Prefix:MRS
First Name:NEILSHA
Middle Name:
Last Name:PERSAUD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:NEILSHA
Other - Middle Name:
Other - Last Name:MAHASE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:10207 97TH AVE
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11416-1717
Mailing Address - Country:US
Mailing Address - Phone:646-932-8535
Mailing Address - Fax:
Practice Address - Street 1:68-80 SCHERMERHORN STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:718-858-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261753-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse