Individual
MISS LILANTHI BALASURIYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
YALE UNIVERSITY DEPARTMENT OF PSYCHIATRY, 300 GEORGE ST, SUITE 901, NEW HAVEN, CT 06511
(203) 785-2095
Mailing address
YALE UNIVERSITY DEPARTMENT OF PSYCHIATRY, 300 GEORGE ST, SUITE 901, NEW HAVEN, CT 06511
(203) 785-2095
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
61701
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/23/2009
Last updated
10/04/2019
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