Provider Demographics
NPI:1376976555
Name:WEERASINGHE, ANYA TAHANI (MD)
Entity Type:Individual
Prefix:DR
First Name:ANYA
Middle Name:TAHANI
Last Name:WEERASINGHE
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 1:1290 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:860-972-9093
Mailing Address - Fax:
Practice Address - Street 1:2265 5TH AVE
Practice Address - Street 2:APT MC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-2019
Practice Address - Country:US
Practice Address - Phone:347-323-6421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY289151207R00000X
282N00000X
CT71174207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No282N00000XHospitalsGeneral Acute Care Hospital