Provider Demographics
NPI:1063144608
Name:KALAICHELVAN, ANUSHA (DDS)
Entity type:Individual
Prefix:MISS
First Name:ANUSHA
Middle Name:
Last Name:KALAICHELVAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GUSTAVE L. LEVY PLACE, BOX 1187
Mailing Address - Street 2:THE MOUNT SINAI HOSPITAL -DEPT OF DENTISTRY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-241-7488
Mailing Address - Fax:
Practice Address - Street 1:1 GUSTAVE L. LEVY PLACE,
Practice Address - Street 2:THE MOUNT SINAI HOSPITAL -DEPT OF DENTISTRY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-7488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2023-03-29
Deactivation Date:2023-03-13
Deactivation Code:
Reactivation Date:2023-03-29
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program