Provider Demographics
NPI:1336604008
Name:ABEYEWARDENE, MENAKA (MD)
Entity Type:Individual
Prefix:DR
First Name:MENAKA
Middle Name:
Last Name:ABEYEWARDENE
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 1:165 FARMSTEAD RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:425
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ST. JOHN'S EPISCOPAL HOSPITAL
Practice Address - Street 2:327 BEACH 19TH STREET
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691
Practice Address - Country:US
Practice Address - Phone:718-869-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program