Provider Demographics
NPI:1790253342
Name:MCCLOSKEY, BRANDON JAMES
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:JAMES
Last Name:MCCLOSKEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:FRACKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17931-1609
Mailing Address - Country:US
Mailing Address - Phone:570-590-9575
Mailing Address - Fax:
Practice Address - Street 1:360 WESTMINSTER DR
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-2737
Practice Address - Country:US
Practice Address - Phone:814-644-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist