Individual
DR. HENRIETTA M. MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
NEMOURS PEDIATRICS PHILADELPHIA PIKE, 222 PHILADELPHIA PIKE, WILMINGTON, DE 19809-3166
(302) 761-4660
(302) 761-4666
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
C10007873
DE
208D00000X
General Practice Physician
Primary
C10007873
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101519114
—
PA
05
—
149039
—
NJ
05
—
4096487
—
MD
Enumeration date
09/28/2006
Last updated
09/29/2011
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