Provider Demographics
NPI:1497264915
Name:MAHON, YUDITH O (RN)
Entity Type:Individual
Prefix:
First Name:YUDITH
Middle Name:O
Last Name:MAHON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:110 W 114TH ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-3057
Mailing Address - Country:US
Mailing Address - Phone:917-535-5910
Mailing Address - Fax:212-933-4335
Practice Address - Street 1:110 WEST 114TH STREET APT. 1B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026
Practice Address - Country:US
Practice Address - Phone:917-535-5910
Practice Address - Fax:212-933-4335
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY738966163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse