Provider Demographics
NPI:1316387939
Name:WICKRAMAARATCHI, SHYAMA DILANI (DO)
Entity Type:Individual
Prefix:DR
First Name:SHYAMA
Middle Name:DILANI
Last Name:WICKRAMAARATCHI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1850 E PARK AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-6706
Mailing Address - Country:US
Mailing Address - Phone:814-234-8800
Mailing Address - Fax:814-235-1133
Practice Address - Street 1:1850 E PARK AVE STE 201
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803
Practice Address - Country:US
Practice Address - Phone:814-234-8800
Practice Address - Fax:814-235-1133
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS019340207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease