Provider Demographics
NPI:1306051446
Name:DRISCOLL, TERRI (CA)
Entity type:Individual
Prefix:MS
First Name:TERRI
Middle Name:
Last Name:DRISCOLL
Suffix:
Gender:F
Credentials:CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 US HIGHWAY 46 STE 6
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-3206
Mailing Address - Country:US
Mailing Address - Phone:973-448-1500
Mailing Address - Fax:973-448-1510
Practice Address - Street 1:382 US HIGHWAY 46 STE 6
Practice Address - Street 2:
Practice Address - City:BUDD LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07828-3206
Practice Address - Country:US
Practice Address - Phone:973-448-1500
Practice Address - Fax:973-448-1510
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00022000171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist