Gooneratne, Tilak C

Gooneratne, Tilak C is an individual health care provider with primary practice located at 345 N Main St Ste 248, West Hartford CT 06117. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Gooneratne, Tilak C can be contacted via phone (860) 231-8453.

Contact Information

Primary practice address
345 N Main St Ste 248 West Hartford CT 06117
Phone: (860) 231-8453
Fax: (860) 523-4061
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 023723 Connecticut

Profile Details

NPI number 1265400329
LBN Legal business name Gooneratne, Tilak C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265400329 NPPES
Connecticut Other 010023723CT02 ANTHEM BCBS
Connecticut Other 021749 ANTHEM BCBS

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