Provider Demographics
NPI:1184668162
Name:CALLAGHAN, STEVEN (DMD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:CALLAGHAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SECOND ST
Mailing Address - Street 2:OCEAN HEALTH INITIATIVES
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701
Mailing Address - Country:US
Mailing Address - Phone:732-363-6699
Mailing Address - Fax:
Practice Address - Street 1:6 HENRY ST
Practice Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-3058
Practice Address - Country:US
Practice Address - Phone:845-831-3349
Practice Address - Fax:845-831-0793
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052221122300000X
NJ22DI02247101122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02791904Medicaid