| Doctor Name: | DEBRA ANNE REILLY |
| NPI Number: | 1134561194 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PNP |
| License Number: | F382398-1 |
| Business Practice Address: | 815 Hallock Avenue Port Jefferson Station, NY - 11776 |
| Business Phone Number: | 6313317267 |
| Business Fax Number: | |
| Mailing Address: | 815 Hallock Ave, PORT JEFFERSON STATION |
| State: | NY |
| Postal Code: | 117761244 |
| Phone Number: | 6313317267 |
| Fax Number: | |
| NPI Enumeration Date: | 07/18/2013 |
| NPI Last Update Date: | 09/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | F382398-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |