Provider Demographics
NPI:1841067428
Name:PERSAUD, LAWRENCE SANJAY (RN)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:SANJAY
Last Name:PERSAUD
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-5110
Mailing Address - Country:US
Mailing Address - Phone:845-641-8530
Mailing Address - Fax:
Practice Address - Street 1:78 MEADOW LN
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-5110
Practice Address - Country:US
Practice Address - Phone:845-641-8530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY541675163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent