| Doctor Name: | MRS. SUSAN MARIE MAHONEY |
| NPI Number: | 1003191628 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 033802-1 |
| Business Practice Address: | 1635 Ohio St Watertown, NY - 136013032 |
| Business Phone Number: | 3157867285 |
| Business Fax Number: | |
| Mailing Address: | 28273 Rockledge Dr, CHAUMONT |
| State: | NY |
| Postal Code: | 136220533 |
| Phone Number: | 7815811852 |
| Fax Number: | |
| NPI Enumeration Date: | 10/14/2011 |
| NPI Last Update Date: | 10/14/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 033802-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |