Provider Demographics
NPI:1033314646
Name:MAHONEY BRIONES, ERIN KATHLEEN (MD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:KATHLEEN
Last Name:MAHONEY BRIONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:KATHLEEN
Other - Last Name:MAHONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:CHARLESTOWN HEALTHCARE CENTER
Mailing Address - Street 2:73 HIGH STREET
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3026
Mailing Address - Country:US
Mailing Address - Phone:617-724-8135
Mailing Address - Fax:617-724-9334
Practice Address - Street 1:CHARLESTOWN HEALTHCARE CENTER
Practice Address - Street 2:73 HIGH STREET
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02139-3026
Practice Address - Country:US
Practice Address - Phone:617-724-8135
Practice Address - Fax:617-724-9334
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA242803208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics