MEDICARE: DR JAMES G REILLY DO PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1144501024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR JAMES G REILLY DO PC

Provider Business Mailing Address
First Line	:	668 CASTLETON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-2044
Country	:	US
Telephone Number	:	718-448-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	668 CASTLETON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-2044
Country	:	US
Telephone Number	:	718-448-4300
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JAMES REILLY
Credential	:	MD
Telephone Number	:	718-448-4300

Provider Enumeration Date	:	09/06/2011
Last Update Date	:	02/19/2019

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