Provider Demographics
NPI:1629247697
Name:MAHONEY HOROHOE AND GARNEAU PTRS
Entity Type:Organization
Organization Name:MAHONEY HOROHOE AND GARNEAU PTRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:LANG
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-334-4200
Mailing Address - Street 1:3875 E HENRIETTA RD
Mailing Address - Street 2:
Mailing Address - City:HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14467-9147
Mailing Address - Country:US
Mailing Address - Phone:585-334-4200
Mailing Address - Fax:585-334-2515
Practice Address - Street 1:3875 E HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467-9147
Practice Address - Country:US
Practice Address - Phone:585-334-4200
Practice Address - Fax:585-334-2515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY33565AMedicare PIN