Individual
DR. MICHAEL H REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
223 N VAN DIEN AVE, RIDGEWOOD, NJ 07450-2726
(201) 447-8242
(201) 447-8657
Mailing address
223 N VAN DIEN AVE, RIDGEWOOD, NJ 07450-2726
(201) 447-8242
(201) 447-8657
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
123239-1
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
25MA03562000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4692501
—
NJ
Enumeration date
11/17/2006
Last updated
09/21/2012
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