Provider Demographics
NPI:1497881239
Name:MAHONY, ERIN MARGARET (MD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARGARET
Last Name:MAHONY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 CONCORD AVE
Mailing Address - Street 2:DOOR #4
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1048
Mailing Address - Country:US
Mailing Address - Phone:617-491-5111
Mailing Address - Fax:617-491-5222
Practice Address - Street 1:799 CONCORD AVENUE
Practice Address - Street 2:BELMONT CAMBRIDGE HEALTH CARE
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138
Practice Address - Country:US
Practice Address - Phone:617-491-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233991208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110078640/AMedicaid
MA110078640/AMedicaid