Basic Information
Provider Information
NPI: 1578561916
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KANNANGARA
FirstName: YOGESWARY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2775 SCHOENERSVILLE RD
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180177307
CountryCode: US
TelephoneNumber: 6108618080
FaxNumber: 6108070366
Practice Location
Address1: 2775 SCHOENERSVILLE RD
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180177307
CountryCode: US
TelephoneNumber: 6108618080
FaxNumber: 6108070366
Other Information
ProviderEnumerationDate: 07/11/2005
LastUpdateDate: 01/07/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XMD018201EPAY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
005072900001 AMERIHEALTHOTHER
5005024201 CAPITAL BLUE CROSSOTHER
00649953000605PA MEDICAID
005072900001 INDEPENDENCE BLUE CROSSOTHER
191979401 UNITED HEALTHCAREOTHER
995473701 CIGNA HEALTHCAREOTHER
P300123201 OXFORD HEALTH PLANSOTHER
005072900001 KEYSTONE HEALTH EASTOTHER
217055601 MAMSIOTHER
13718501 HIGHMARK BLUE SHIELDOTHER
5005024201 KEYSTONE HEALTH CENTRALOTHER
8521501 GEISINGER HEALTH PLANOTHER


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