Dealwis, Watutantrige Takshan

Dealwis, Watutantrige Takshan is an individual health care provider with primary practice located at 223 N Van Dien Ave , Ridgewood NJ 07450-2726. He recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as his primary health care specialty. Dealwis, Watutantrige Takshan can be contacted via phone (201) 447-8586.

Contact Information

Primary practice address
223 N Van Dien Ave Ridgewood NJ 07450-2726
Phone: (201) 447-8586
Fax: (201) 447-8491
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 25MA04286900 New Jersey

Profile Details

NPI number 1396798120
LBN Legal business name Dealwis, Watutantrige Takshan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Nov 15th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396798120 NPPES
New Jersey MEDICAID 6358900

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