Provider Demographics
NPI:1932973377
Name:MAHER, CONOR
Entity Type:Individual
Prefix:
First Name:CONOR
Middle Name:
Last Name:MAHER
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 1:23 PELLANA RD
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-4726
Mailing Address - Country:US
Mailing Address - Phone:781-298-5016
Mailing Address - Fax:
Practice Address - Street 1:23 PELLANA RD
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-4726
Practice Address - Country:US
Practice Address - Phone:781-298-5016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician