Look up the most recent NPI and PECOS records

Mark Callahan

Internal Medicine

Allopathic & Osteopathic Physicians

PECOS Enrollment

Based on the most recent information from CMS, provider Mark Callahan does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1194803890
Provider Type
Individual
Full Name
Callahan, Mark
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
11/1/2006
Last Updated
1/24/2012

Contact Information

Practice Location

17 E 102nd St, New York, NY 10029-5204

(212) 241-6585

(212) 824-2335

Mailing Location

1 Gustave L Levy Pl, Box 3000, New York, NY 10029-6500

(212) 987-3100

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 197116 New York

Provider Identifiers

ID	Description	Issuer
ID 01523326	Description Medicaid	Issuer Unlisted New York

Mark Callahan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Sirbu, Laura

Meah, Yasmin S

Allyn, Katherine

Escobar, Christian

Lewis, Frederick

Fifer, Kenneth M

Truglio, Joseph

Jubelt, Lindsay E

Goel, Pakhi

Galperin, Irene