Provider Demographics
NPI:1356066625
Name:GAJANAYAKE, AMA (PA-C)
Entity type:Individual
Prefix:
First Name:AMA
Middle Name:
Last Name:GAJANAYAKE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 OAK PL
Mailing Address - Street 2:
Mailing Address - City:BLAKESLEE
Mailing Address - State:PA
Mailing Address - Zip Code:18610-7834
Mailing Address - Country:US
Mailing Address - Phone:570-350-4156
Mailing Address - Fax:
Practice Address - Street 1:511 VNA RD FL 1
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-8502
Practice Address - Country:US
Practice Address - Phone:570-664-8115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA066037363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical