Provider Demographics
NPI:1073294534
Name:JINADASA, ARUMABADUGE MEHAN
Entity Type:Individual
Prefix:
First Name:ARUMABADUGE
Middle Name:MEHAN
Last Name:JINADASA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W 35TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2538
Mailing Address - Country:US
Mailing Address - Phone:833-646-3222
Mailing Address - Fax:833-646-3222
Practice Address - Street 1:10400 N BAEHR RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-4472
Practice Address - Country:US
Practice Address - Phone:833-646-3222
Practice Address - Fax:833-646-3222
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician