Healthcare Provider Details

I. General information

NPI: 1376598813
Provider Name (Legal Business Name): JAMES DAVID BRESNAHAN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 CLUB LN
BLAIRSVILLE PA
15717-7957
US

IV. Provider business mailing address

520 JEFFERSON AVE SUITE 400
JEANNETTE PA
15644-2538
US

V. Phone/Fax

Practice location:
  • Phone: 724-537-4321
  • Fax: 724-539-2449
Mailing address:
  • Phone: 724-527-8060
  • Fax: 724-522-4002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110010950
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: