Individual
CHARLES MAHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
628 BLUE POINT RD, HOLTSVILLE, NY 11742-1812
(631) 627-3735
Mailing address
628 BLUE POINT RD, HOLTSVILLE, NY 11742-1812
(631) 627-3735
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
593136
NY
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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