Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | MD033001E | PA |
Y | 207V00000X | Obstetrician & Gynecologist | MD033001E | PA |
NPI | 1417987272 |
---|---|
Provider Name | Deborah A Driscoll |
First Address | Philadelphia, PA 19104-4206 |
Second Address | Philadelphia, PA 19104-4206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 18/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001087366 | (05) | PA |
6985700 | (05) | NJ |
C31423 | (02) | PA |