Individual
MARIA M MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
25 CHURCH ST, WILKES BARRE, PA 18765-3812
(570) 808-8831
(570) 808-8845
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
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
03/09/2006
Last updated
11/02/2017
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