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NPI Code Detail

MEDICARE: MR. THOMAS WILLIAM MCMAHON M.S.W.

MEDICARE: MR. THOMAS WILLIAM MCMAHON M.S.W.
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
11041C0700XClinical Social Worker104113MA

General Provider Information

NPI Number : 1518988922
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS WILLIAM MCMAHON M.S.W.
Provider Business Mailing Address
First Line : 52 LOCUST ST
Second Line :
City : LYNN
State : MA
Zip : 01904-2910
Country : US
Telephone Number : 978-852-5046
Fax Number :
Provider Business Practice Location Address
First Line : 435 NEWBURY ST
Second Line : SUITE 220
City : DANVERS
State : MA
Zip : 01923-1065
Country : US
Telephone Number : 978-852-5046
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 07/08/2007

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