Individual
DR. REILLY WASHINGTON COCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 DATES DR, ITHACA, NY 14850
(607) 257-5858
(607) 257-1718
Mailing address
101 DATES DR, ITHACA, NY 14850-1342
(607) 277-2365
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
245671
NY
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
245671
NY
208000000X
Pediatrics Physician
245671
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02908116
—
NY
05
—
102029680001
—
PA
01
—
AA0598
MEDICARE GROUP
NY
Enumeration date
04/16/2007
Last updated
04/28/2022
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