DR. KRISHNA VIJAY PERSAUD MD

Allergy and Immunology

Williamson, New York

Provider NPI: 1508829284

Provider Information:
DR. KRISHNA VIJAY PERSAUD MD


Practice Location:
4418 E RIDGE RD WILLIAMSON MEDICAL PLLC WILLIAMSON, NY 14589 US
Tel: 315-589-4641  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	207K00000X	Physicians Allergy & Immunology	NY	205585
Y	207R00000X	Physicians Internal Medicine	NY	205585

Other Provider Identifiers:

Issuer	Number	State	Type
PREFERRED CARE ALLERGY	102914AA	NY	01
BLUE CHOICE IM	010000058	NY	01
BLUE CHOICE ALLERGY	030000058	NY	01
	01535859	NY	05
PREFERRED CARE IM	102914BJ	NY	01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin

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