Healthcare Provider Details

I. General information

NPI: 1780704783
Provider Name (Legal Business Name): DEBORAH MAHONEY P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2007
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 WAYNE MEMORIAL DR
GOLDSBORO NC
27534-9494
US

IV. Provider business mailing address

93 RIPSHIN RD # 152
TROUTDALE VA
24378-2506
US

V. Phone/Fax

Practice location:
  • Phone: 919-587-4394
  • Fax:
Mailing address:
  • Phone: 516-659-5140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0110008305
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number007698
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number9114456
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-14099
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: