Individual
DR. MARY D. DRIESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
160 MAIN ST, PENN YAN, NY 14527-1204
(315) 536-2752
(315) 536-4005
Mailing address
PO BOX 423, PENN YAN, NY 14527-0423
(315) 531-9102
(315) 531-9103
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
175630
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01108927
—
NY
Enumeration date
05/27/2005
Last updated
01/22/2013
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