Provider Demographics
NPI:1275848228
Name:MAHONEY, WILLIAM (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:MAHONEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HALICK CT
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-1373
Mailing Address - Country:US
Mailing Address - Phone:732-354-0065
Mailing Address - Fax:
Practice Address - Street 1:4201 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08260-4601
Practice Address - Country:US
Practice Address - Phone:609-729-1050
Practice Address - Fax:609-523-2595
Is Sole Proprietor?:No
Enumeration Date:2010-08-15
Last Update Date:2010-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01444300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist