Provider Demographics
NPI:1477590115
Name:EDIRISINGHE, NAYOMI K (MD)
Entity Type:Individual
Prefix:
First Name:NAYOMI
Middle Name:K
Last Name:EDIRISINGHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7 ALFRED STREET
Mailing Address - Street 2:SUITE #306
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-1900
Mailing Address - Country:US
Mailing Address - Phone:781-756-2308
Mailing Address - Fax:781-756-4798
Practice Address - Street 1:7 ALFRED STREET
Practice Address - Street 2:SUITE #306
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-1900
Practice Address - Country:US
Practice Address - Phone:781-756-2308
Practice Address - Fax:781-756-4798
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2010-04-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA224882208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery