Provider Demographics
NPI:1770271496
Name:PERERA, AYODYA RUKSHANI (MD)
Entity type:Individual
Prefix:DR
First Name:AYODYA
Middle Name:RUKSHANI
Last Name:PERERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AYODYA
Other - Middle Name:RUKSHANI
Other - Last Name:WADUWAWARAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:308 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-3808
Mailing Address - Country:US
Mailing Address - Phone:201-418-1000
Mailing Address - Fax:201-418-3148
Practice Address - Street 1:308 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-3808
Practice Address - Country:US
Practice Address - Phone:201-418-1000
Practice Address - Fax:201-418-3148
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program