Provider Demographics
NPI:1174549448
Name:JAYAWARDENA, HILDA (MD)
Entity type:Individual
Prefix:
First Name:HILDA
Middle Name:
Last Name:JAYAWARDENA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SHERWOOD HEIGHTS
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-3408
Mailing Address - Country:US
Mailing Address - Phone:914-474-3271
Mailing Address - Fax:845-297-0179
Practice Address - Street 1:17 SHERWOOD HEIGHTS
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-3408
Practice Address - Country:US
Practice Address - Phone:914-474-3271
Practice Address - Fax:845-297-0179
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYS 1231192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
B13698Medicare UPIN
NY3565410Medicare ID - Type Unspecified