MEDICARE: DEBRA GROVE-MAHONEY M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246Q00000X	Pathology Specialist/Technologist	MD041383L	PA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
12	220021412	OTHER	PA	RR MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000126583	OTHER	PA	UNISON
2	30003495	OTHER	PA	KEYSTONE MERCY
3	50056056	OTHER	PA	CAPITAL BLUE CROSS/KEYSTONE HEALTH PLAN CENTRAL
4	5685185	OTHER	PA	AETNA-NON HMO
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	0737893000	OTHER	PA	INDEPENDENCE BLUE CROSS
7	76907	OTHER	PA	GEISINGER
8	1537630	OTHER	PA	GATEWAY
9	000539004	OTHER	PA	HIGHMARK
10	20011072	OTHER	PA	MERCY
11	847766	OTHER	PA	AETNA-HMO

NPI Number	:	1982677720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA GROVE-MAHONEY M.D.

Provider Business Mailing Address
First Line	:	555 N DUKE ST
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17602-2250
Country	:	US
Telephone Number	:	717-544-5511
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 N DUKE ST
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17602-2250
Country	:	US
Telephone Number	:	717-544-5511
Fax Number	:

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

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	03/30/2011