Provider Demographics
NPI:1184619116
Name:SENEVIRATNE, ARUNA M (MD)
Entity type:Individual
Prefix:
First Name:ARUNA
Middle Name:M
Last Name:SENEVIRATNE
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 1:1189 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-3536
Mailing Address - Country:US
Mailing Address - Phone:212-960-8877
Mailing Address - Fax:
Practice Address - Street 1:1189 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-3536
Practice Address - Country:US
Practice Address - Phone:212-960-8877
Practice Address - Fax:212-980-7888
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207523207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ASO5876610Medicare ID - Type Unspecified
I16952Medicare UPIN