Individual
JOAN CATHERINE MAHONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
732 SMITHTOWN BYP STE 206, SMITHTOWN, NY 11787-5020
(631) 485-6074
(631) 532-4060
Mailing address
2094 WANTAGH AVE, WANTAGH, NY 11793-3914
(516) 528-2617
(516) 781-2542
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
431760
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
405325
NY
Other
Enumeration date
07/06/2020
Last updated
09/19/2024
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