Provider Demographics
NPI:1891082533
Name:POOVALINGAM, KAMALOSHINI (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMALOSHINI
Middle Name:
Last Name:POOVALINGAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 LAFAYETTE RD
Mailing Address - Street 2:APT 604
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13205-2930
Mailing Address - Country:US
Mailing Address - Phone:315-395-6333
Mailing Address - Fax:
Practice Address - Street 1:211 LAFAYETTE ROAD
Practice Address - Street 2:604
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13205
Practice Address - Country:US
Practice Address - Phone:315-395-6333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program