Provider Demographics
NPI:1609181650
Name:MAHONEY, JOSEPHINE H (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:H
Last Name:MAHONEY
Suffix:
Gender:F
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 1:1708 WILDWOOD BLVD
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:NJ
Practice Address - Zip Code:08242-1406
Practice Address - Country:US
Practice Address - Phone:609-886-4141
Practice Address - Fax:609-886-2253
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
NJ28RI01983900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist