Individual
LOUIS MUDANNAYAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
506 6TH ST, BROOKLYN, NY 11215-3609
(718) 780-5246
(718) 780-3257
Mailing address
17 MONTGOMERY PL, BROOKLYN, NY 11215-2302
(516) 569-0696
(516) 569-3677
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
225697
NY
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
12256987
NY
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
225697
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02333420
—
NY
Enumeration date
05/27/2006
Last updated
09/13/2023
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