Provider Demographics
NPI:1700897725
Name:CLUGSTON, DAVID JAY (CRNP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JAY
Last Name:CLUGSTON
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-2013
Mailing Address - Country:US
Mailing Address - Phone:215-822-6919
Mailing Address - Fax:
Practice Address - Street 1:433 CAREDEAN DR
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-1321
Practice Address - Country:US
Practice Address - Phone:215-823-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP005769C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health