Healthcare Provider Details
I. General information
NPI: 1083640817
Provider Name (Legal Business Name): HOLLY A. DRISCOLL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/23/2006
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14 PROSPECT STREET
MILFORD MA
01757-3003
US
IV. Provider business mailing address
124 GROVE STREET SUITE 305
FRANKLIN MA
02038-3156
US
V. Phone/Fax
- Phone: 508-473-1190
- Fax: 508-482-5416
- Phone: 508-528-5392
- Fax: 508-541-2420
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | PA1069 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | PA1069 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: