Provider Demographics
NPI:1487658464
Name:KULANGARA, SARA (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:KULANGARA
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 1:2901 TELESTAR CT STE 300
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1263
Mailing Address - Country:US
Mailing Address - Phone:703-591-1688
Mailing Address - Fax:703-591-1445
Practice Address - Street 1:130 PARK ST SE STE 100
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4626
Practice Address - Country:US
Practice Address - Phone:703-281-1265
Practice Address - Fax:703-255-0571
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101055548207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC031737700Medicaid
DC770001354OtherRAILROAD MEDICARE DC #
VA060062645OtherRAILROAD MEDICARE VA #
MD189518400Medicaid
VA1487658464Medicaid
VA1487658464Medicaid
DC901648C42Medicare PIN
VA060062645OtherRAILROAD MEDICARE VA #
VA060062645OtherRAILROAD MEDICARE VA #
DC901648C42Medicare PIN
VA060000742Medicare PIN