Provider Demographics
| NPI: | 1144725136 |
|---|---|
| Name: | DAYARATNA, SASHI M (MD) |
| Entity type: | Individual |
| Prefix: | DR |
| First Name: | SASHI |
| Middle Name: | M |
| Last Name: | DAYARATNA |
| Suffix: | |
| Gender: | F |
| Credentials: | MD |
| Other - Prefix: | |
| Other - First Name: | SASHI |
| Other - Middle Name: | |
| Other - Last Name: | ABEYSEKARA |
| Other - Suffix: | |
| Other - Last Name Type: | Other Name |
| Other - Credentials: | |
| Mailing Address - Street 1: | PO BOX 37174 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BALTIMORE |
| Mailing Address - State: | MD |
| Mailing Address - Zip Code: | 21297-3174 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 571-423-5699 |
| Mailing Address - Fax: | 571-423-5698 |
| Practice Address - Street 1: | 2700 PROSPERITY AVE STE 270 |
| Practice Address - Street 2: | |
| Practice Address - City: | FAIRFAX |
| Practice Address - State: | VA |
| Practice Address - Zip Code: | 22031-4321 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 703-698-2431 |
| Practice Address - Fax: | 571-665-6878 |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2018-03-29 |
| Last Update Date: | 2022-11-03 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 390200000X | ||
| VA | 0101275790 | 207RG0300X, 207R00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 207RG0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
| No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |