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Individual

MS. KERRY B REILLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
55 LAKE AVENUE NORTH, DEPARTMENT OF SURGERY, WORCESTER, MA 01655
(508) 334-3278
(508) 334-7284
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
006856-1
NY
363A00000X
Physician Assistant
Primary
2083
MA
363A00000X
Physician Assistant
5601003110
MI
363A00000X
Physician Assistant
PA00392
RI

Other

Enumeration date
12/06/2006
Last updated
01/13/2012
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