Provider Demographics
NPI: | 1184660474 |
---|---|
Name: | MAHONEY, JOHN J |
Entity Type: | Individual |
Prefix: | |
First Name: | JOHN |
Middle Name: | J |
Last Name: | MAHONEY |
Suffix: | |
Gender: | M |
Credentials: | |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 33465 |
Mailing Address - Street 2: | |
Mailing Address - City: | BELFAST |
Mailing Address - State: | ME |
Mailing Address - Zip Code: | 04915-0612 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 888-985-2727 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1400 ROUTE 70 E |
Practice Address - Street 2: | |
Practice Address - City: | CHERRY HILL |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08034-2240 |
Practice Address - Country: | US |
Practice Address - Phone: | 888-985-2727 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-06-22 |
Last Update Date: | 2023-04-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NJ | 25MB04990100 | 207LP2900X |
PA | OS005329L | 207LP2900X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NJ | 22-1994560 | Other | UNITED HEALTHCARE/OXFORD |
PA | 23-2919275 | Other | PROCURA MANAGEMENT |
PA | P00117313 | Other | RAILROAD MEDICARE |
PA | 22-1994560 | Other | HEALTH AMERICA/HEALTH ASSURANCE |
PA | 23-2919275 | Other | GREAT WEST HEALTHCARE |
PA | 0100369000 | Other | AMERIHEALTH |
PA | 22-1994560 | Other | UNITED HEALTHCARE/OXFORD |
NJ | 23-2919275 | Other | HORIZON BLUE CROSS BLUE SHIELD |
PA | 30026840 | Other | KEYSTONE MERCY |
PA | 435453 | Other | PA BLUE SHIELD |
PA | 50088203 | Other | CAPITAL BLUE CROSS-CLINICAL PAIN MANAGMENT |
PA | P00125184 | Other | RAILROAD MEDICARE |
NJ | 1171572 | Other | AETNA |
NJ | 22-1994560 | Other | FIRST MCO |
PA | 23-2919275 | Other | UNITED HEALTHCARE/OXFORD |
NJ | 23-2919275 | Other | UNITED HEALTHCARE/OXFORD |
PA | 1184660474 | Other | BRAVO |
PA | 22-1994560 | Other | QUALCARE |
PA | 22-1994560 | Other | FIRST MCO |
NJ | 22-1994560 | Other | HORIZON BLUE CROSS BLUE SHIELD |
PA | 23-2919275 | Other | FIRST MCO |
PA | 30009932 | Other | HORIZON MERCY |
NJ | 1201983 | Other | AETNA |
NJ | 23-2919275 | Other | FIRST MCO |
PA | 23-2919275 | Other | HEALTH AMERICA/HEALTH ASSURANCE |
PA | 23-2919275 | Other | QUALCARE |
PA | 23-2919275 | Other | DEVON |
PA | 22-1994560 | Other | PROCURA MANAGEMENT |
PA | 22-1994560 | Other | GREAT WEST HEALTHCARE |
PA | 3107710 | Other | AETNA |
PA | 3801579 | Other | AETNA |
PA | 6039566 | Other | CIGNA |
PA | 001966534 | Medicaid | |
PA | 0100369000 | Other | KEYSTONE HEALTH PLAN EAST |
PA | 22-1994560 | Other | DEVON |
PA | 30026841 | Other | KEYSTONE MERCY |
PA | 435453 | Other | PERSONAL CHOICE |
PA | 50084647 | Other | CAPITAL BLUE CROSS |
PA | 5614434 | Other | FIRST HEALTH NETWORK |
PA | P00125184 | Other | RAILROAD MEDICARE |
PA | 50088203 | Other | CAPITAL BLUE CROSS-CLINICAL PAIN MANAGMENT |
NJ | 22-1994560 | Other | HORIZON BLUE CROSS BLUE SHIELD |
PA | 22-1994560 | Other | GREAT WEST HEALTHCARE |
PA | 23-2919275 | Other | PROCURA MANAGEMENT |
PA | E13295 | Medicare UPIN | |
PA | 001966534 | Medicaid | |
PA | 056011S8T | Medicare PIN |