Individual
LISA REEVES MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
565 ROUTE 25A, SUITE 4, MILLER PLACE, NY 11764-2663
(631) 821-9200
(631) 821-3266
Mailing address
565 ROUTE 25A, SUITE 4, MILLER PLACE, NY 11764-2663
(631) 821-9200
(631) 821-3266
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
124569
NY
Other
Enumeration date
03/16/2006
Last updated
07/21/2022
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