Individual
DR. BENJAMIN JOSEPH MAHONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP, APRN
Contact information
Practice address
160 ALLEN ST, RUTLAND, VT 05701-4560
(802) 775-7111
Mailing address
1 LONG WHARF DR STE 321, NEW HAVEN, CT 06511-5946
(203) 781-4600
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
009732
CT
363LP2300X
Primary Care Nurse Practitioner
Primary
101.0137520
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004217099
—
CT
05
—
008039745
—
CT
05
—
008056033
—
CT
05
—
008056168
—
CT
05
—
008068298
—
CT
05
—
008103793
—
CT
Enumeration date
06/22/2021
Last updated
11/18/2024
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