Provider Demographics
NPI:1306470919
Name:PERSAUD, ANUPAM ARAMINTAH (LMSW)
Entity type:Individual
Prefix:
First Name:ANUPAM
Middle Name:ARAMINTAH
Last Name:PERSAUD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 LEXINGTON AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-3912
Mailing Address - Country:US
Mailing Address - Phone:212-658-0977
Mailing Address - Fax:
Practice Address - Street 1:124 E 40TH ST RM 402
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1764
Practice Address - Country:US
Practice Address - Phone:929-276-1838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY096315104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker