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Organization

EXECUTIVE MEWS PEDIATRICS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIA MAHONEY MD (OWNER/PHYSICIAN)
(215) 830-8870
Entity
Organization

Contact information

Practice address
2300 COMPUTER AVE, SUITE H-44, WILLOW GROVE, PA 19090-1742
(215) 830-8870
Mailing address
2300 COMPUTER AVE, SUITE H-44, WILLOW GROVE, PA 19090-1742
(215) 830-8870

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD063137L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0017043070004
PA
Enumeration date
07/25/2012
Last updated
07/25/2012
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