Provider Demographics
NPI:1861870651
Name:CHANDRASEKARAN, ANITA CHRISTINA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:CHRISTINA
Last Name:CHANDRASEKARAN
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Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:196 WATERFORD PKWY S STE 201B
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385-1234
Mailing Address - Country:US
Mailing Address - Phone:860-524-2610
Mailing Address - Fax:860-524-2615
Practice Address - Street 1:196 WATERFORD PKWY S STE 201B
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-1234
Practice Address - Country:US
Practice Address - Phone:860-524-2610
Practice Address - Fax:860-524-2615
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT66609207RR0500X
390200000X
CA145728390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology