Provider Demographics
NPI:1538844717
Name:VITHARANA, ANJALEE
Entity type:Individual
Prefix:
First Name:ANJALEE
Middle Name:
Last Name:VITHARANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-1414
Mailing Address - Country:US
Mailing Address - Phone:347-935-2462
Mailing Address - Fax:
Practice Address - Street 1:50 2ND ST
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-1414
Practice Address - Country:US
Practice Address - Phone:347-935-2462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY791131163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse