Provider Demographics
NPI:1710935051
Name:MAHONEY, CYNTHIA ELLEN (MSN, RN, CS)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ELLEN
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:MSN, RN, CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1857 ROBESON ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-4218
Mailing Address - Country:US
Mailing Address - Phone:508-674-4227
Mailing Address - Fax:
Practice Address - Street 1:25W OLD WESTPORT RD
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-2513
Practice Address - Country:US
Practice Address - Phone:508-493-3137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN00963364SP0809X, 364SP0809X
MARN177000364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult