MEDICARE: MAUREEN L MOHNEY PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	001303-1	NY

General Provider Information

NPI Number	:	1083740500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN L MOHNEY PA

Provider Business Mailing Address
First Line	:	419 HOBSONS CHOICE
Second Line	:
City	:	WEBSTER
State	:	NY
Zip	:	14580-8418
Country	:	US
Telephone Number	:	585-872-3304
Fax Number	:	585-529-5129

Provider Business Practice Location Address
First Line	:	774 W MAIN ST
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14611-2331
Country	:	US
Telephone Number	:	585-279-5601
Fax Number	:	585-529-5121

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	12/14/2022

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