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General NPI Number Information
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NPI Number | 1437741402
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Entity Type | Individual
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Provider Name | CARLOS DANIEL DRIGGS
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Gender | Male
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Dates
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Enumeration Date | 02/10/2021
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Last Update Date | 09/07/2024
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Provider Practice Location Address
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Address Line | 1957 WILLIAMSBRIDGE RD
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City | BRONX
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State | NY
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Zip | 10461-1604
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Country | US
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Telephone | 718-828-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 3 MONROE AVE
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City | DUMONT
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State | NJ
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Zip | 07628-2714
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Country | US
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Telephone | 201-951-7476
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 692655
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F347403
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License Number State | NY
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