MEDICARE: DR. DANIEL N DRISCOLL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	152157	MA
2	2086S0122X	Plastic and Reconstructive Surgery Physician	152157	MA

General Provider Information

NPI Number	:	1013999523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL N DRISCOLL MD

Provider Business Mailing Address
First Line	:	2000 WASHINGTON ST
Second Line	:	SUITE 444
City	:	NEWTON LOWER FALLS
State	:	MA
Zip	:	02462-1655
Country	:	US
Telephone Number	:	617-244-0990
Fax Number	:	617-969-4044

Provider Business Practice Location Address
First Line	:	2000 WASHINGTON ST STE 444
Second Line	:
City	:	NEWTON LOWER FALLS
State	:	MA
Zip	:	02462-1608
Country	:	US
Telephone Number	:	617-244-0990
Fax Number	:	617-969-4044

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	12/03/2010

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