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Individual

JAMES GERARD REILLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1050 CLOVE RD, STATEN ISLAND, NY 10301-3627
(718) 816-6440
Mailing address
55 WATER ST, 12TH FLOOR, CREDENTIALING, NEW YORK, NY 10041-0004
(646) 680-2888
(516) 542-5556

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
191290
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01651234
NY
Enumeration date
08/09/2006
Last updated
02/06/2017
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