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General NPI Number Information
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NPI Number | 1013449867
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Entity Type | Individual
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Provider Name | EDWARD J O'REILLY MD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2017
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 201 CEDAR ST SE STE 306
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4932
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Country | US
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Telephone | 505-224-7478
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Fax |
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Provider Business Mailing Address
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Address Line | DERRADDA HOUSE CAVANACAW ROAD
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City | ARMAGH
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State | ULSTER
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Zip | BT602AB
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Country | IE
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD2024-1235
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License Number State | NM
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