CORINNE MAHONEY PA NPI 1003871898

in Boston, MA

About CORINNE MAHONEY

Corinne Mahoney is a provider in Boston, MA with more than 20 years of experience. The NPI number assigned to this provider is 1003871898. The provider is registered as an individual and their NPI record was last updated 10 years ago. Corinne Mahoney is registered with Medicare and accepts claims assignment.

NPI1003871898 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name CORINNE MAHONEY PA
Provider Location Address111 BROOKLINE AVE BOSTON, MA 02215 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address147 MILK ST PROVIDER ENROLLMENT - 9TH FLOOR BOSTON, MA 02109 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderFemale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Medical School NameOTHER
Graduation Year1998
Is Sole Proprietor?N/A
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date04-18-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date07-08-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

CORINNE MAHONEY PA
111 BROOKLINE AVE
BOSTON, MA
ZIP 02215
Phone: (617) 421-1000
Fax: (617) 421-6084
Get Directions

Mailing Address

CORINNE MAHONEY PA
147 MILK ST
PROVIDER ENROLLMENT - 9TH FLOOR
BOSTON, MA
ZIP 02109
Phone: (617) 559-8053
Fax: (617) 421-3487

Primary Taxonomy

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant1006MAN/A

Taxonomy Description: a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

2363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical1006MAN/A

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
AP1701MEDICARE ID-TYPE UNSPECIFIED (04)MA
P57595MEDICARE UPIN (02)MA

Map Location


CORINNE MAHONEY PA address is 111 BROOKLINE AVE BOSTON, MA 02215