Provider Demographics
NPI:1154583458
Name:GUNASEKARA, ATHULA (MD)
Entity type:Individual
Prefix:
First Name:ATHULA
Middle Name:
Last Name:GUNASEKARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 E 101ST ST APT 5A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6530
Mailing Address - Country:US
Mailing Address - Phone:212-241-4029
Mailing Address - Fax:212-876-1493
Practice Address - Street 1:3 E 101ST ST APT 5A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6530
Practice Address - Country:US
Practice Address - Phone:212-241-4029
Practice Address - Fax:212-876-1493
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP62129207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology