Provider Demographics
NPI:1326199670
Name:MCMAHON, ANN CARNEY (AUD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:CARNEY
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ALETHIA DR # U-1085
Mailing Address - Street 2:
Mailing Address - City:STORRS
Mailing Address - State:CT
Mailing Address - Zip Code:06269-1085
Mailing Address - Country:US
Mailing Address - Phone:860-486-2629
Mailing Address - Fax:860-486-4948
Practice Address - Street 1:2 ALETHIA DR # U-1085
Practice Address - Street 2:
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06269-1085
Practice Address - Country:US
Practice Address - Phone:860-486-2629
Practice Address - Fax:860-486-4948
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT192237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT206715OtherWELLCARE
CT4067674Medicaid
CT4082343Medicaid
CT3058249OtherAETNA
CT7586386OtherAETNA
CT11092OtherCONNECTICARE
CT206715OtherPREFERRED ONE
CT730000192CT01OtherANTHEM
CT730000192CT01OtherANTHEM