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General NPI Number Information
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NPI Number | 1255448395
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Entity Type | Individual
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Provider Name | DONALD T REILLY M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 12/03/2010
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Provider Practice Location Address
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Address Line | 235 CYPRESS ST
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City | BROOKLINE
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State | MA
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Zip | 02445-6776
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Country | US
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Telephone | 617-738-8642
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Fax | 617-738-5045
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Provider Business Mailing Address
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Address Line | 235 CYPRESS ST
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City | BROOKLINE
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State | MA
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Zip | 02445-6776
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Country | US
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Telephone | 617-738-8642
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Fax | 617-738-5045
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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 | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 46658
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License Number State | MA
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