Ayesha I Patabendi Koralalage, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

332594-1 Issued in NY

Practice address

26 Dumont Ave
Staten Island, NY 10305-1450

Phone

(718) 667-8510

NPI assigned

Feb 1, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1881159051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34A GREENTREE LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 DUMONT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051450",
            "telephone_number": "718-667-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATABENDI KORALALAGE",
        "first_name": "AYESHA",
        "middle_name": "I",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "332594-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole M Passanante, PA
• Katherine Ines Passaro
• Karen Passburg
• Michael Pastena
• Peter Coronel Pastolero, M.D.
• Anju M Patel, PA
• Arjun Patel, MD
• Chandin Vinekumar Patel, P.T
• Darshita Patel, PT
• Devanshi Patel, PA

• Licensed Practical Nurse in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.