| Lisle Medical Arts Center | |
| 
					66 Johnson Hill Road Pob 338 Lisle NY 13797-0338  | |
| (607) 692-3844 | |
| (607) 692-3846 | 
| Full Name | Lisle Medical Arts Center | 
|---|---|
| Speciality | Clinic/center - Primary Care | 
| Location | 66 Johnson Hill Road, Lisle, New York | 
| Authorized Official Name and Position | Daniel J. Driscoll (OWNER) | 
| Authorized Official Contact | 6076923844 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Lisle Medical Arts Center 66 Johnson Hill Road Pob 338 Lisle NY 13797-0338 Ph: (607) 692-3844  | Lisle Medical Arts Center 66 Johnson Hill Road Pob 338 Lisle NY 13797-0338 Ph: (607) 692-3844  | 
| NPI Number | 1598817207 | 
|---|---|
| Provider Enumeration Date | 01/16/2007 | 
| Last Update Date | 05/21/2008 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1598817207 | NPI | - | NPPES | 
| 00491447 | Medicaid | NY | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 113141 (New York) | Primary |