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General NPI Number Information
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NPI Number | 1942223573
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Entity Type | Individual
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Provider Name | GREGORY MARK CLOSKEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 09/04/2020
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Provider Practice Location Address
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Address Line | 830 OLD LANCASTER RD SUITE 206
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City | BRYN MAWR
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State | PA
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Zip | 19010-3118
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Country | US
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Telephone | 610-525-8110
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Fax |
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Provider Business Mailing Address
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Address Line | 830 OLD LANCASTER RD SUITE 206
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City | BRYN MAWR
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State | PA
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Zip | 19010-3118
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Country | US
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Telephone | 610-525-8110
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD038267L
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License Number State | PA
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