Individual
KRISTIN MCCLOSKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
230 N BROAD ST, PHILADELPHIA, PA 19102-1121
(215) 762-2365
Mailing address
133 POPLAR AVE, WAYNE, PA 19087-3501
(610) 574-1459
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MT201897
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT201897
MT LICENSE
PA
Enumeration date
05/31/2012
Last updated
05/31/2012
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