Individual
PATRICK P REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
51 FANNING AVE, HAMPTON BAYS, NY 11946
(631) 603-5996
Mailing address
51 FANNING AVE, HAMPTON BAYS, NY 11946
(631) 603-5996
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
010044
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010044
—
NY
Enumeration date
07/08/2019
Last updated
07/08/2019
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