Individual
EMMY MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 KENYON AVE, WAKEFIELD, RI 02879-4216
(401) 788-3337
(401) 788-3939
Mailing address
PO BOX 229, WAKEFIELD, RI 02880-0229
(401) 788-3337
(401) 788-3939
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12145
RI
208M00000X
Hospitalist Physician
12145
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7058828
—
RI
01
—
709003710
GROUP MEDICARE
RI
Enumeration date
07/24/2006
Last updated
11/23/2015
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