| 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 |