Provider Demographics
NPI:1346773074
Name:O'CALLAHAN, ELIZABETH MARY CONWAY (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARY CONWAY
Last Name:O'CALLAHAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:129 W 29TH ST FL 10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5105
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:415-520-0904
Practice Address - Street 1:165 SMITH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-6337
Practice Address - Country:US
Practice Address - Phone:212-441-4380
Practice Address - Fax:212-867-4353
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2021-12-01
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Provider Licenses
StateLicense IDTaxonomies
NY305869207Q00000X
MA285671207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine