DR. TILAK C GOONERATNE MD NPI 1265400329

NPI Information

NPI: 1265400329
Provider Name: DR. TILAK C GOONERATNE, MD
Classification: Pediatrics - 2080A0000X
Entity Type: Individual

Specialization: Adolescent Medicine

Address:
345 N MAIN ST
STE 248
WEST HARTFORD, CT
ZIP 06117
Phone: (860) 231-8453
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DR. Tilak C Gooneratne, MD is an adolescent medicine pediatrics in West Hartford, CT. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. DR. Tilak C Gooneratne, MD NPI is 1265400329. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

345 N MAIN ST
STE 248
WEST HARTFORD, CT
ZIP 06117
Phone: (860) 231-8453
Fax: (860) 523-4061

The enumeration date for this NPI number is 3/14/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080A0000X	Pediatrics	Adolescent Medicine	023723	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	010023723CT02	OTHER	CONNECTICUT	ANTHEM BCBS
2	021749	OTHER	CONNECTICUT	CONNECTICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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