Provider Demographics
NPI:1437725082
Name:CHARATHCHANDRA SEBANAYAGAM, VINOJA (MD)
Entity type:Individual
Prefix:
First Name:VINOJA
Middle Name:
Last Name:CHARATHCHANDRA SEBANAYAGAM
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:VINOJA
Other - Middle Name:
Other - Last Name:SEBANAYAGAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:750 EAST ADAMS ST.
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210
Mailing Address - Country:US
Mailing Address - Phone:315-464-5910
Mailing Address - Fax:
Practice Address - Street 1:750 EAST ADAMS ST.
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-5910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334757207R00000X
MI4301510726207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine