Individual
JENNIFER THRASHER REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2500 ENGLISH CREEK AVE, EGG HARBOR TOWNSHIP, NJ 08234-5549
(609) 407-2332
Mailing address
110 KNIGHTS BRIDGE WAY, MAYS LANDING, NJ 08330-2051
(850) 814-8611
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
25MP00330200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MP00330200
NJ BOARD OF MEDICAL EXAMINERS- PHYSICIAN ASSISTANT LICENSE
NJ
Enumeration date
03/17/2014
Last updated
03/17/2014
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