Healthcare Provider Details

I. General information

NPI: 1831038231
Provider Name (Legal Business Name): JANE MACMAHON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 HOSFORD AVE
LEONARDO NJ
07737-1734
US

IV. Provider business mailing address

49 HOSFORD AVE
LEONARDO NJ
07737-1734
US

V. Phone/Fax

Practice location:
  • Phone: 908-601-7741
  • Fax:
Mailing address:
  • Phone: 908-601-7741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number26NR17621600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: