Individual
KIM MARIE NEENAN-REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
7200 DOUGLASTON PKWY, MAIN FLOOR, DOUGLASTON, NY 11362-1941
(718) 461-3065
Mailing address
40 HARMON ST, LONG BEACH, NY 11561-2708
(516) 351-1095
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
308746
NY
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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