National Provider Identifier

Mary D. Driesch, MD

Mary D. Driesch, MD is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Penn Yan, NY and a listed phone number of (315) 536-2752.

NPI 1508869199Penn Yan, NYFamily Medicine Physician

Profile Overview

NPI
1508869199
Provider Type
Individual
Primary Specialty
Family Medicine Physician
Enumeration Date
May 27, 2005
Last Updated
January 22, 2013

Practice Location

  • 160 Main St
  • Penn Yan, NY 14527-1204

Phone: (315) 536-2752

Mailing Address

  • PO Box 423
  • Penn Yan, NY 14527-0423

Specialties

  • Family Medicine Physician (207Q00000X)
Full Record
NPI
1508869199
Entity Type
Individual
Last Name
Driesch
First Name
Mary
Middle Name
D.
Name Prefix
Dr.
Credential
MD
Mailing Street Address
PO Box 423
Mailing City
Penn Yan
Mailing State
NY
Mailing ZIP Code
14527-0423
Mailing Country
US
Mailing Phone
(315) 531-9102
Mailing Fax
(315) 531-9103
Practice Street Address
160 Main St
Practice City
Penn Yan
Practice State
NY
Practice ZIP Code
14527-1204
Practice Country
US
Practice Phone
(315) 536-2752
Practice Fax
(315) 536-4005
Enumeration Date
May 27, 2005
Last Updated
January 22, 2013
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Medicine Physician (207Q00000X)
Other Identifiers
01108927 (NY)