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General NPI Number Information
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NPI Number | 1356557003
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Entity Type | Individual
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Provider Name | ELIZABETH ANN REILLY PT
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 421 COLUMBIA ST EDDY COHOES REHABILITATION CENTER
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City | COHOES
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State | NY
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Zip | 12047-2217
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Country | US
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Telephone | 518-238-4014
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Fax |
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Provider Business Mailing Address
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Address Line | 782 WATERVLIET SHAKER RD
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City | LATHAM
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State | NY
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Zip | 12110-2209
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Country | US
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Telephone | 518-785-1637
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 010529-1
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License Number State | NY
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