Doctor Name: | MS. JUDITH A REILLY |
NPI Number: | 1134445877 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PMHNP |
License Number: | 401256 |
Business Practice Address: | 9 Brooke Club Dr Unit 2 Ossining, NY - 105627806 |
Business Phone Number: | 9144327592 |
Business Fax Number: | |
Mailing Address: | 9 Brooke Club Dr, Unit 2 OSSINING |
State: | NY |
Postal Code: | 105627806 |
Phone Number: | 5166980347 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2010 |
NPI Last Update Date: | 08/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 401256 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |