Provider Demographics
NPI:1831912088
Name:CLOHESSY, ERICA LEIGH
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LEIGH
Last Name:CLOHESSY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 REJE AVE
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-8138
Mailing Address - Country:US
Mailing Address - Phone:732-754-8002
Mailing Address - Fax:
Practice Address - Street 1:1300 HWY 35 UNIT 204
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-3533
Practice Address - Country:US
Practice Address - Phone:732-531-6400
Practice Address - Fax:609-991-6220
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15139300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily