Organization
TIKIRI RATNAYAKE M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROON NAZ (CEO)
(219) 756-2100
Entity
Organization
Contact information
Practice address
1910 CALUMET AVE, VALPARAISO, IN 46383-2704
(219) 464-8115
Mailing address
PO BOX 1249, VALPARAISO, IN 46384-1249
(219) 464-8115
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
IN01028333
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084568
BLUE CROSS PIN
IN
01
—
000000085652
BLUE CROSS PIN
IN
Enumeration date
05/20/2008
Last updated
08/28/2012
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