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Individual

DR. THOMAS PETER REILLY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
92 ADAMS ST, BURLINGTON, VT 05401-4525
(802) 651-7533
Mailing address
92 ADAMS ST, BURLINGTON, VT 05401-4525
(802) 651-7533

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
048 0000298
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5432
VT
01
966233
MVP
Enumeration date
09/27/2005
Last updated
07/08/2007
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