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General NPI Number Information
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NPI Number | 1659796738
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Entity Type | Organization
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Legal Business Name | VYJANTHANATH ROHAN GUNASINGHAM, M.D.
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Dates
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Enumeration Date | 02/25/2014
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Last Update Date | 02/25/2014
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Provider Practice Location Address
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Address Line | 725 ORCHARD PARK RD SUITE D
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City | WEST SENECA
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State | NY
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Zip | 14224-3352
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Country | US
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Telephone | 716-748-6002
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Fax | 716-748-6002
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Provider Business Mailing Address
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Address Line | 725 ORCHARD PARK RD SUITE D
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City | WEST SENECA
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State | NY
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Zip | 14224-3352
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Country | US
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Telephone | 716-748-6002
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Fax | 716-748-6002
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Authorized Official
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Title or Position | MANAGER
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Name | MS. DEB PYTLAK
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Credential |
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Telephone | 716-208-4766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 249369-1
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License Number State | NY
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