Individual
THILAN PRASANGA WIJESEKERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 YORK STREET, CB-2041, NEW HAVEN, CT 06510-3220
(203) 688-4744
(203) 688-4740
Mailing address
1450 CHAPEL ST, ADULT PRIMARY CARE CENTER, NEW HAVEN, CT 06511-4405
(203) 789-4044
(203) 789-3007
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
55270
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/06/2013
Last updated
09/27/2018
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