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General NPI Number Information
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NPI Number | 1962650135
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Entity Type | Individual
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Provider Name | DANIEL C. REYLY PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/29/2008
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 221 MAHALANI ST
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City | WAILUKU
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State | HI
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Zip | 96793-2526
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Country | US
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Telephone | 808-868-8382
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Fax |
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Provider Business Mailing Address
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Address Line | 221 MAHALANI ST
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City | WAILUKU
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State | HI
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Zip | 96793-2526
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Country | US
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Telephone | 808-868-8382
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 23 012731
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | AMD-479
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0983
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License Number State | NH
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