Provider Demographics
NPI:1477711190
Name:CLOHESSY, BRIAN J (DO)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:J
Last Name:CLOHESSY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RED LION AND KNIGHTS ROAD
Mailing Address - Street 2:FRANKFORD HOSPITAL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114
Mailing Address - Country:US
Mailing Address - Phone:215-612-4000
Mailing Address - Fax:
Practice Address - Street 1:RED LION AND KNIGHTS ROAD
Practice Address - Street 2:FRANKFORD HOSPITAL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114
Practice Address - Country:US
Practice Address - Phone:215-612-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOTO10945207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services