Healthcare Provider Details

I. General information

NPI: 1396835286
Provider Name (Legal Business Name): ANJANA KUNDU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/17/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE CHILDREN'S PLAZA CHILDREN'S ANESTHESIA GROUP, INC.
DAYTON OH
45404-1815
US

IV. Provider business mailing address

ONE CHILDREN'S PLAZA CHILDREN'S ANESTHESIA GROUP, INC.
DAYTON OH
45404-1815
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-3350
  • Fax: 937-641-6145
Mailing address:
  • Phone: 937-641-3350
  • Fax: 937-641-6145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD00042730
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number35.122037
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberMD00042730
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number314280
License Number StateNY
# 5
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number35-122037
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: