Healthcare Provider Details

I. General information

NPI: 1184159717
Provider Name (Legal Business Name): JAMES J. BRESNAHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2017
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

891 BALTIMORE PIKE
SPRINGFIELD PA
19064-3954
US

IV. Provider business mailing address

891 BALTIMORE PIKE
SPRINGFIELD PA
19064-3954
US

V. Phone/Fax

Practice location:
  • Phone: 215-789-6264
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number25MA11471300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD468155
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberC1-0025053
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number25MA11471300
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberC1-0025053
License Number StateDE
# 6
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberMD468155
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: