Provider Demographics
NPI:1801209390
Name:DISSANAYAKA, NADISHANI THAMALI (DO)
Entity Type:Individual
Prefix:DR
First Name:NADISHANI
Middle Name:THAMALI
Last Name:DISSANAYAKA
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:2301 E. EVESHAM ROAD
Mailing Address - Street 2:BLDG 800, SUITE 115
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4509
Mailing Address - Country:US
Mailing Address - Phone:856-424-5005
Mailing Address - Fax:856-424-4716
Practice Address - Street 1:2301 E. EVESHAM ROAD
Practice Address - Street 2:BLDG 800, SUITE 115
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4509
Practice Address - Country:US
Practice Address - Phone:856-424-5005
Practice Address - Fax:856-424-4716
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2019-07-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB10538600207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology