Provider Demographics
NPI:1992251078
Name:SIRIWARDHANA, DAYANA NANDA L (NP)
Entity type:Individual
Prefix:MR
First Name:DAYANA NANDA
Middle Name:L
Last Name:SIRIWARDHANA
Suffix:
Gender:M
Credentials:NP
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Mailing Address - Street 1:200 MILL ROAD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:480 HAWTHORN ST
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-3729
Practice Address - Country:US
Practice Address - Phone:508-973-9150
Practice Address - Fax:508-973-1955
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2024-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN2314835363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner