MEDICARE: ASHANTHI GAJAWEERA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	229095	NY

General Provider Information

NPI Number	:	1356342497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHANTHI GAJAWEERA MD

Provider Business Mailing Address
First Line	:	2290 EAST AVENUE, 4TH FLOOR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14610
Country	:	US
Telephone Number	:	585-201-8478
Fax Number	:	800-396-8709

Provider Business Practice Location Address
First Line	:	2290 EAST AVENUE, 4TH FLOOR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14610
Country	:	US
Telephone Number	:	585-201-8478
Fax Number	:	800-396-8709

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/22/2025

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