Lisa Reeves Mahoney
Dermatologist
565 Route 25a Suite 4
Miller Place
, New York 11764-2663
Lisa Reeves Mahoney
Dermatologist
565 Route 25a Suite 4
Miller Place
, New York 11764-2663
(631) 821-3266
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Lisa Reeves Mahoney
- 565 Route 25a Suite 4
- Miller Place, NY
- Zip : 11764-2663
- Fax : (631) 821-3266
- Phone : (631) 821-9200
Second Address
- Lisa Reeves Mahoney
- 565 Route 25a Suite 4
- Miller Place, NY
- Zip : 11764-2663
- Fax : (631) 821-3266
- Phone : (631) 821-9200
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | 124569 | NY |
National Provider Identifier
| NPI | 1033188669 |
|---|---|
| Provider Name | Lisa Reeves Mahoney |
| First Address | Miller Place, NY 11764-2663 |
| Second Address | Miller Place, NY 11764-2663 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/03/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| C05266 | (02) | NY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
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)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.