Basic Information
| Provider Information | |||||||||
| NPI: | 1205974722 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAHONEY | ||||||||
| FirstName: | SHARON | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1070 IYANNOUGH ROAD | ||||||||
| Address2: | IORA PRIMARY CARE | ||||||||
| City: | HYANNIS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089483400 | ||||||||
| FaxNumber: | 8447157919 | ||||||||
| Practice Location | |||||||||
| Address1: | 1070 IYANNOUGH ROAD | ||||||||
| Address2: | IORA PRIMARY CARE | ||||||||
| City: | HYANNIS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089483400 | ||||||||
| FaxNumber: | 8447157919 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2007 | ||||||||
| LastUpdateDate: | 11/15/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 75314 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3052711 | 05 | MA | MEDICAID | 69657 | 01 | MA | HARVARD PILGRIM | OTHER | 757797 | 01 | MA | TUFTS | OTHER | J08612 | 01 | MA | BS | OTHER |