Provider Demographics
NPI:1730431016
Name:MAHONEY, ERIN JEAN (FNP)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:JEAN
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:FNP
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Other - Credentials:
Mailing Address - Street 1:23 NORTH STREET
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1208
Mailing Address - Country:US
Mailing Address - Phone:585-394-8170
Mailing Address - Fax:585-348-2020
Practice Address - Street 1:23 NORTH STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1208
Practice Address - Country:US
Practice Address - Phone:585-394-8170
Practice Address - Fax:585-348-2020
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2023-05-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY337403363LF0000X
NYF337403-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily