Provider Demographics
NPI:1356462899
Name:BANDARANAYAKE, ILIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ILIAN
Middle Name:
Last Name:BANDARANAYAKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 2ND ST NW
Mailing Address - Street 2:UNITY HEALTH CARE CCNV
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-2003
Mailing Address - Country:US
Mailing Address - Phone:202-508-0515
Mailing Address - Fax:202-508-0525
Practice Address - Street 1:425 2ND ST NW
Practice Address - Street 2:UNITY HEALTH CARE CCNV
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-2003
Practice Address - Country:US
Practice Address - Phone:202-508-0515
Practice Address - Fax:202-508-0525
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0359802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry