Provider Demographics
NPI:1073692497
Name:ANURA M RAJAPAKSA AND TRIKANTE N RAJAPAKSA PHYSICIANS PC
Entity Type:Organization
Organization Name:ANURA M RAJAPAKSA AND TRIKANTE N RAJAPAKSA PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRIKANTE
Authorized Official - Middle Name:NALINI
Authorized Official - Last Name:RAJAPAKSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-579-0593
Mailing Address - Street 1:1965 BROADWAY
Mailing Address - Street 2:APT 24K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5928
Mailing Address - Country:US
Mailing Address - Phone:212-579-0593
Mailing Address - Fax:
Practice Address - Street 1:3117 KINGSBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3943
Practice Address - Country:US
Practice Address - Phone:718-543-5514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-05
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119607207RC0200X, 207RP1001X
NY122456207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty