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Individual

KEVIN CALLAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
90 MANHATTAN AVE, WHITE PLAINS, NY 10603-2734
(914) 593-6098
Mailing address
90 MANHATTAN AVE, WHITE PLAINS, NY 10603-2734
(914) 593-6098

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
242092289
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04685356
NY
Enumeration date
05/22/2017
Last updated
07/21/2022
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