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General NPI Number Information
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NPI Number | 1003425968
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Entity Type | Organization
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Legal Business Name | REILLEY PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 03/08/2022
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Provider Practice Location Address
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Address Line | 625 WEST DRYDEN RD
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City | FREEVILLE
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State | NY
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Zip | 13068-9746
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Country | US
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Telephone | 607-319-2480
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Fax | 607-261-1190
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Provider Business Mailing Address
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Address Line | 625 W DRYDEN RD
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City | FREEVILLE
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State | NY
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Zip | 13068-9746
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Country | US
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Telephone | 607-319-2480
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Fax | 607-261-1190
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Authorized Official
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Title or Position | MANAGING MEMBER, OWNER
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Name | ANNE MARIE REILLEY
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Credential | PT, DPT
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Telephone | 607-319-2480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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