Provider Demographics
NPI:1255732392
Name:MAHONEY, MATTHEW (DO)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:MAHONEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 TURNPIKE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5812
Mailing Address - Country:US
Mailing Address - Phone:978-975-3435
Mailing Address - Fax:978-685-6641
Practice Address - Street 1:542 TURNPIKE ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5812
Practice Address - Country:US
Practice Address - Phone:978-975-3435
Practice Address - Fax:978-685-6641
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4784156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician