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1457333866

NPI Code Detail

MEDICARE: DR. MARCELLE JENNIFER REILLY D.O.

MEDICARE: DR. MARCELLE JENNIFER REILLY D.O.

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	207Q00000X	Family Medicine Physician	227525	NY
2	207Q00000X	Family Medicine Physician	DR.0059961	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7157690	OTHER	NY	AETNA
2	131794	OTHER	NY	GHI-HMO
3	10075805	OTHER	NY	CDPHP
4	3004538	OTHER	NY	MVP HEALTHCARE
5	080820000089	OTHER	NY	FIDELIS
6	028867	OTHER	CO	KAISER COMMERCIAL NUMBER
7	300931	OTHER	NY	SENIOR WHOLE HEALTH
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	6016D1	OTHER	NY	EMPIRE BC
10	000404619006	OTHER	NY	BSNENY
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457333866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCELLE JENNIFER REILLY D.O.

Provider Business Mailing Address
First Line	:	10350 E DAKOTA AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-1314
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16290 E QUINCY AVE
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80015-1594
Country	:	US
Telephone Number	:	303-338-4545
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2005
Last Update Date	:	06/04/2021

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Directions to “ DR. MARCELLE JENNIFER REILLY D.O.” Practice Location

Language	Start Address	Practice Location

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