Provider Demographics
NPI:1457991176
Name:DRISCOLL, JOSEPH STEPHEN
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:STEPHEN
Last Name:DRISCOLL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ST. ALBANS SCHOOL / MOUNT ST, ALBAN
Mailing Address - Street 2:3001 WISCONSIN AVE
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016
Mailing Address - Country:US
Mailing Address - Phone:202-497-0920
Mailing Address - Fax:
Practice Address - Street 1:ST. ALBANS SCHOOL / MOUNT ST, ALBAN
Practice Address - Street 2:3001 WISCONSIN AVE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016
Practice Address - Country:US
Practice Address - Phone:202-497-0920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer