MEDICARE: DR. ELVIRA CALLAHAN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0000X	Sports Medicine Podiatrist	NY005404	NY
2	213ES0131X	Foot Surgery Podiatrist	NY005404	NY
3	213EP1101X	Primary Podiatric Medicine Podiatrist	NY005404	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	4895450001	OTHER	NY	MEDICARE DME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588647879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELVIRA CALLAHAN DPM

Provider Business Mailing Address
First Line	:	6259 108TH ST APT 1L
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-1307
Country	:	US
Telephone Number	:	718-275-7590
Fax Number	:	718-313-3840

Provider Business Practice Location Address
First Line	:	6259 108TH ST APT 1L
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-1307
Country	:	US
Telephone Number	:	718-275-7590
Fax Number	:	718-313-3840

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	03/14/2025

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