Susan Marie Mahoney

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

033802-1 Issued in NY

Practice address

1635 Ohio St
Watertown, NY 13601-3032

Phone

(315) 786-7285

NPI assigned

Oct 14, 2011

Last updated

Oct 14, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Susan Mahoney Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1003191628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28273 ROCKLEDGE DR",
            "city": "CHAUMONT",
            "state": "NY",
            "postal_code": "136220533",
            "telephone_number": "781-581-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 OHIO ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013032",
            "telephone_number": "315-786-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-14",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "033802-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "MAHONEY",
            "credential": "PHYSICAL THERAPIST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mercedes Mackin
• Linda Macqueen, NP
• Sabrina Kay Madden, RN
• Magnetic Imaging Center/Open MRI, LLC
• Cynthia N. Maguire, PSYD
• Majak Podiatry, P.C.
• Andrew Reilly Majak, DPM
• Walter Hudson Majak, DPM
• Marissa Makuch
• Libby Anne Malcolm

• Pediatric Physical Therapist in Watertown, NY
• Providers in Watertown, NY by specialty
• Pediatric Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.