Individual
MS. ELAINE MARIE MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MN
Contact information
Practice address
119 WINDSOR ST, CAMBRIDGE, MA 02139
(617) 665-3638
Mailing address
119 WINDSOR ST, CAMBRIDGE, MA 02139-3647
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
146700
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
NA
MA
01
—
0
MANAGER NO BILLING
—
Enumeration date
05/16/2017
Last updated
05/16/2017
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