Healthcare Provider Details

I. General information

NPI: 1548831274
Provider Name (Legal Business Name): CHRISTOPHER WILLIAM DRISCOLL SR. PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2021
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 BIRCH ST
MILFORD MA
01757-3585
US

IV. Provider business mailing address

163 MAIN ST STE 6-G
MEDWAY MA
02053-1533
US

V. Phone/Fax

Practice location:
  • Phone: 781-551-0999
  • Fax:
Mailing address:
  • Phone: 508-682-5102
  • Fax: 508-296-8873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2335482
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: