DON ANTON DAYANTHA WISIDAGAMA

STATEN ISLAND, NY
NPI1437628260
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2018-11-22
Last Update Date2018-11-22
Business Address
DON ANTON DAYANTHA WISIDAGAMA PA
253 SUMNER PL
STATEN ISLAND, NY 10301-2835
Phone number: 347-636-6950
Mailing Address
DON ANTON DAYANTHA WISIDAGAMA PA
253 SUMNER PL
STATEN ISLAND, NY 10301-2835
Phone number: 347-636-6950