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:
Health care specialties
| Specialty | Code | License # | 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 19 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 | 1265400329 | NPPES |
| Connecticut | Other | 010023723CT02 | ANTHEM BCBS |
| Connecticut | Other | 021749 | ANTHEM BCBS |
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