Dissanayake, Imara R
Dissanayake, Imara R is an individual health care provider with primary practice located at 5501 Old York Rd , Phila PA 19144. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Dissanayake, Imara R can be contacted via phone (215) 456-6970.Contact Information
Primary practice address
5501 Old York Rd
Phila PA 19144
Phone: (215) 456-6970
Fax: (215) 456-7154
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | MD072898L | Pennsylvania |
Profile Details
| NPI number | 1295796969 |
|---|---|
| LBN Legal business name | Dissanayake, Imara R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 31st, 2006 |
| Last updated | Dec 9th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295796969 | NPPES |
| Pennsylvania | MEDICAID | 001866922 |
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