Provider Demographics
NPI:1093737215
Name:CALLANAN, EMILY M (APRN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:CALLANAN
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:222 ROUTE 59
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5204
Mailing Address - Country:US
Mailing Address - Phone:845-368-0100
Mailing Address - Fax:845-368-1916
Practice Address - Street 1:222 ROUTE 59
Practice Address - Street 2:SUITE 302
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5204
Practice Address - Country:US
Practice Address - Phone:845-368-0100
Practice Address - Fax:845-368-1916
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NYF332526363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ35580Medicare UPIN