Provider Demographics
NPI:1659521516
Name:MAHON, NOREEN THERESA (PT MS DPT)
Entity Type:Individual
Prefix:DR
First Name:NOREEN
Middle Name:THERESA
Last Name:MAHON
Suffix:
Gender:F
Credentials:PT MS DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 POPLAR DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-1015
Mailing Address - Country:US
Mailing Address - Phone:845-783-3730
Mailing Address - Fax:845-238-2091
Practice Address - Street 1:48 POPLAR DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-1015
Practice Address - Country:US
Practice Address - Phone:845-783-3730
Practice Address - Fax:845-238-2091
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0112572251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics