Provider Demographics
NPI:1184660474
Name:MAHONEY, JOHN J
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:MAHONEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 33465
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0612
Mailing Address - Country:US
Mailing Address - Phone:888-985-2727
Mailing Address - Fax:
Practice Address - Street 1:1400 ROUTE 70 E
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2240
Practice Address - Country:US
Practice Address - Phone:888-985-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB04990100207LP2900X
PAOS005329L207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22-1994560OtherUNITED HEALTHCARE/OXFORD
PA23-2919275OtherPROCURA MANAGEMENT
PAP00117313OtherRAILROAD MEDICARE
PA22-1994560OtherHEALTH AMERICA/HEALTH ASSURANCE
PA23-2919275OtherGREAT WEST HEALTHCARE
PA0100369000OtherAMERIHEALTH
PA22-1994560OtherUNITED HEALTHCARE/OXFORD
NJ23-2919275OtherHORIZON BLUE CROSS BLUE SHIELD
PA30026840OtherKEYSTONE MERCY
PA435453OtherPA BLUE SHIELD
PA50088203OtherCAPITAL BLUE CROSS-CLINICAL PAIN MANAGMENT
PAP00125184OtherRAILROAD MEDICARE
NJ1171572OtherAETNA
NJ22-1994560OtherFIRST MCO
PA23-2919275OtherUNITED HEALTHCARE/OXFORD
NJ23-2919275OtherUNITED HEALTHCARE/OXFORD
PA1184660474OtherBRAVO
PA22-1994560OtherQUALCARE
PA22-1994560OtherFIRST MCO
NJ22-1994560OtherHORIZON BLUE CROSS BLUE SHIELD
PA23-2919275OtherFIRST MCO
PA30009932OtherHORIZON MERCY
NJ1201983OtherAETNA
NJ23-2919275OtherFIRST MCO
PA23-2919275OtherHEALTH AMERICA/HEALTH ASSURANCE
PA23-2919275OtherQUALCARE
PA23-2919275OtherDEVON
PA22-1994560OtherPROCURA MANAGEMENT
PA22-1994560OtherGREAT WEST HEALTHCARE
PA3107710OtherAETNA
PA3801579OtherAETNA
PA6039566OtherCIGNA
PA001966534Medicaid
PA0100369000OtherKEYSTONE HEALTH PLAN EAST
PA22-1994560OtherDEVON
PA30026841OtherKEYSTONE MERCY
PA435453OtherPERSONAL CHOICE
PA50084647OtherCAPITAL BLUE CROSS
PA5614434OtherFIRST HEALTH NETWORK
PAP00125184OtherRAILROAD MEDICARE
PA50088203OtherCAPITAL BLUE CROSS-CLINICAL PAIN MANAGMENT
NJ22-1994560OtherHORIZON BLUE CROSS BLUE SHIELD
PA22-1994560OtherGREAT WEST HEALTHCARE
PA23-2919275OtherPROCURA MANAGEMENT
PAE13295Medicare UPIN
PA001966534Medicaid
PA056011S8TMedicare PIN