Healthcare Provider Details
I. General information
NPI: 1447384730
Provider Name (Legal Business Name): JAMES SCOTT REILEY N.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/16/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
24 GLEN ROAD
SANDY HOOK CT
06482
US
IV. Provider business mailing address
483A HERITAGE VILLAGE
SOUTHBURY CT
06488
US
V. Phone/Fax
- Phone: 203-426-6334
- Fax:
- Phone: 203-264-7246
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175F00000X |
| Taxonomy | Naturopath |
| License Number | 000277 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: