Organization
PRASANNA C WICKREMESINGHE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRASANNA C WICKREMESINGHE MD (DIRECTOR)
(718) 448-0865
Entity
Organization
Contact information
Practice address
481 BARD AVE, STATEN ISLAND, NY 10310-2103
(718) 448-0865
(718) 816-8065
Mailing address
481 BARD AVE, STATEN ISLAND, NY 10310-2103
(718) 448-0865
(718) 816-8065
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
06/18/2008
Last updated
09/29/2008
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