Basic Information
| Provider Information | |||||||||
| NPI: | 1356507297 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAHONEY | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | ADAM | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 725 CHERRINGTON PKWY STE 100 | ||||||||
| Address2: | |||||||||
| City: | MOON TOWNSHIP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151084318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122621000 | ||||||||
| FaxNumber: | 4122622427 | ||||||||
| Practice Location | |||||||||
| Address1: | 725 CHERRINGTON PKWY STE 100 | ||||||||
| Address2: | |||||||||
| City: | MOON TOWNSHIP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122621000 | ||||||||
| FaxNumber: | 4122622427 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2008 | ||||||||
| LastUpdateDate: | 10/01/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | MD450890 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.