Provider Demographics
NPI:1396835286
Name:KUNDU, ANJANA
Entity Type:Individual
Prefix:
First Name:ANJANA
Middle Name:
Last Name:KUNDU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE CHILDREN'S PLAZA
Mailing Address - Street 2:CHILDREN'S ANESTHESIA GROUP, INC.
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45404-1815
Mailing Address - Country:US
Mailing Address - Phone:937-641-3350
Mailing Address - Fax:937-641-6145
Practice Address - Street 1:ONE CHILDREN'S PLAZA
Practice Address - Street 2:CHILDREN'S ANESTHESIA GROUP, INC.
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404-1815
Practice Address - Country:US
Practice Address - Phone:937-641-3350
Practice Address - Fax:937-641-6145
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042730207LP2900X, 207LP3000X
OH35.122037207LP2900X
NY314280207RH0003X
OH35-122037207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
310320OtherINTERNAL ID-MOTOR VEHICLE ID
WA8364440Medicaid
AB39100Medicare ID - Type Unspecified
H91678Medicare UPIN