Individual
MR. PETER J REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
400 BALD HILL RD, SUITE 526, WARWICK, RI 02886-1617
(401) 738-4323
(401) 738-3857
Mailing address
400 BALD HILL RD, SUITE 526, WARWICK, RI 02886-1617
(401) 738-4323
(401) 738-3857
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NPP35094
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
709004108
GROUP MEDICARE
RI
05
—
9025374
—
RI
Enumeration date
08/14/2006
Last updated
07/10/2007
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