Provider Demographics
NPI:1912900432
Name:GUNASINGHAM, VYJANTHANATH ROHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:VYJANTHANATH
Middle Name:ROHAN
Last Name:GUNASINGHAM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:725 ORCHARD PARK RD
Mailing Address - Street 2:STE D
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3352
Mailing Address - Country:US
Mailing Address - Phone:716-748-6002
Mailing Address - Fax:716-210-6252
Practice Address - Street 1:725 ORCHARD PARK RD
Practice Address - Street 2:STE D
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3352
Practice Address - Country:US
Practice Address - Phone:716-667-3200
Practice Address - Fax:716-667-3213
Is Sole Proprietor?:No
Enumeration Date:2005-05-30
Last Update Date:2017-01-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY249369207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0415102OtherINDEPENDENT HEALTH
NY207988064Medicaid
NY000530664001OtherBLUE CROSS BLUE SHIELD
NY080924000024OtherFIDELIS
NY207988064Medicaid
NY000530664001OtherBLUE CROSS BLUE SHIELD