Provider Demographics
NPI:1124396155
Name:MAHONEY-RYAN, PATRICIA ELLEN (RN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ELLEN
Last Name:MAHONEY-RYAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CLARE TER
Mailing Address - Street 2:
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-3201
Mailing Address - Country:US
Mailing Address - Phone:914-779-2257
Mailing Address - Fax:
Practice Address - Street 1:9 CLARE TER
Practice Address - Street 2:
Practice Address - City:TUCKAHOE
Practice Address - State:NY
Practice Address - Zip Code:10707-3201
Practice Address - Country:US
Practice Address - Phone:914-779-2257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY450498-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse