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General NPI Number Information
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NPI Number | 1518959204
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Entity Type | Individual
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Provider Name | DANIEL J. DRISCOLL M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 11/18/2011
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Provider Practice Location Address
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Address Line | 66 JOHNSON HILL RD
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City | LISLE
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State | NY
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Zip | 13797-1403
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Country | US
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Telephone | 607-692-3844
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Fax | 607-692-3846
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Provider Business Mailing Address
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Address Line | 346 GRAND AVE
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City | JOHNSON CITY
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State | NY
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Zip | 13790-2558
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Country | US
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Telephone | 607-729-8156
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Fax | 607-729-3982
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 113141
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License Number State | NY
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