Provider Demographics
NPI:1497975353
Name:ARIYARATHNA, KRISHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISHAN
Middle Name:
Last Name:ARIYARATHNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16730 RIDGEMONT STREET
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:39136-4023
Mailing Address - Country:US
Mailing Address - Phone:402-575-3500
Mailing Address - Fax:
Practice Address - Street 1:5719 NW RADIAL HWY
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-4141
Practice Address - Country:US
Practice Address - Phone:402-575-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-51888208M00000X
NE5378207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist