Goonewardene, Ian

Goonewardene, Ian is an individual health care provider with primary practice located at 420 S 5Th Ave , West Reading PA 19611-2143. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Goonewardene, Ian can be contacted via phone (484) 628-5455.

Contact Information

Primary practice address
420 S 5Th Ave West Reading PA 19611-2143
Phone: (484) 628-5455
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD064260L Pennsylvania

Profile Details

NPI number 1679522676
LBN Legal business name Goonewardene, Ian
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2006
Last updated Mar 29th, 2018 - about 6 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 1679522676 NPPES
Pennsylvania MEDICAID 001709312

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