Provider Demographics
NPI:1912191990
Name:MAHONE, PATRICIA LEE (RN, MAC, LAC, DIPLOM)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:LEE
Last Name:MAHONE
Suffix:
Gender:F
Credentials:RN, MAC, LAC, DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 HODGE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-1905
Mailing Address - Country:US
Mailing Address - Phone:716-887-2919
Mailing Address - Fax:
Practice Address - Street 1:187 HODGE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-1905
Practice Address - Country:US
Practice Address - Phone:716-887-2919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003514-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist