Healthcare Provider Details

I. General information

NPI: 1033314646
Provider Name (Legal Business Name): ERIN KATHLEEN MAHONEY BRIONES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN KATHLEEN MAHONEY M.D.

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 02/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHARLESTOWN HEALTHCARE CENTER 73 HIGH STREET
CHARLESTOWN MA
02139-3026
US

IV. Provider business mailing address

CHARLESTOWN HEALTHCARE CENTER 73 HIGH STREET
CHARLESTOWN MA
02139-3026
US

V. Phone/Fax

Practice location:
  • Phone: 617-724-8135
  • Fax: 617-724-9334
Mailing address:
  • Phone: 617-724-8135
  • Fax: 617-724-9334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number242803
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: