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BRIAN D CALLAHAN
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1932153301
Individual Registrant: BRIAN D CALLAHAN
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
480 STATE ROUTE 28 SUITE 1 BOICEVILLE, NY 12412-2820 US
Tel: 845-657-7820 Fax: 845-657-6016
Tel: 845-657-7820 Fax: 845-657-6016
Contact information for business:
480 STATE ROUTE 28 SUITE 1 BOICEVILLE, NY 12412-2820 US
Tel: 845-657-7820 Fax: 845-657-6016
Tel: 845-657-7820 Fax: 845-657-6016
Registration Information:
NPI: 1932153301
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | NY | F330832 |
| N | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | NY | F330832 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 01927462 | NY | 05 |
