Individual
DR. ANDREA JEANNE REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
388 COMMONWEALTH AVE MBB, MGH BACK BAY, BOSTON, MA 02215-2800
(617) 267-7171
(617) 262-2608
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 267-7171
(617) 262-2608
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
156935
MA
208000000X
Pediatrics Physician
Primary
156935
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0107981
—
MA
01
—
156935
TUFTS HEALTH PLAN
MA
01
—
J22565
BCBS MA
MA
Enumeration date
01/18/2006
Last updated
09/05/2012
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