Provider Demographics
NPI:1548404635
Name:MCCLOSKEY, PAUL E (PT)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:E
Last Name:MCCLOSKEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:942 GRAYSON DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01119-1547
Mailing Address - Country:US
Mailing Address - Phone:413-783-3964
Mailing Address - Fax:413-783-2190
Practice Address - Street 1:942 GRAYSON DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01119-1547
Practice Address - Country:US
Practice Address - Phone:413-783-3964
Practice Address - Fax:413-783-2190
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18546225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist