Individual
ELISA M KAVANAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
440 MAMARONECK AVE STE 502, HARRISON, NY 10528-2433
(914) 472-1000
(914) 472-1008
Mailing address
440 MAMARONECK AVE STE 502, HARRISON, NY 10528-2433
(914) 472-1000
(914) 472-1008
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
005920
NY
213ES0103X
Foot & Ankle Surgery Podiatrist
005920
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000082282
GHI HMO
—
01
—
1582677
CIGNA
NY
01
—
160452P
HIP
—
01
—
2404394
UNITED
—
01
—
3C6175
HEALTHNET
NY
01
—
6298866
GHI PPO
—
01
—
P2738692
OXFORD
—
01
—
PH7951
BCBS
—
Enumeration date
07/27/2006
Last updated
08/01/2022
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