Individual
MR. TIMOTHY J DRISCOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 2ND AVE, LONG BRANCH, NJ 07740
(732) 222-5200
Mailing address
1028 PINE ST APT 3, PHILADELPHIA, PA 19107-6007
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
26NR18328900
NJ
367500000X
Certified Registered Nurse Anesthetist
122086
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
26NJ00849000
NJ
Other
Enumeration date
05/11/2018
Last updated
11/01/2021
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