Marianne Irene Reilly, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

000339 Issued in CT

Practice address

30 Shelburne Rd
Stamford, CT 06902-3628

Phone

(203) 276-1000

NPI assigned

Feb 20, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1225206543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 SHELBURNE RD/W BROAD ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "06904",
            "telephone_number": "203-276-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 SHELBURNE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023628",
            "telephone_number": "203-276-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "MARIANNE",
        "middle_name": "IRENE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-20",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "000339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT STATE LICENSE",
            "identifier": "000339",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Refocus Surgical Services LLC
• Reforming Rehab Corp
• David Regelmann, MD
• Regency Family Dental
• Regency Heights of Stamford, LLC
• Mary D Reilly, D.P.M
• Miriam Reinetz
• Rejuvenate Joint and Spine PLLC
• Rejuvian LLC
• David Remiszewski, DMD, MDSC, FACP

• Surgical Physician Assistant in Stamford, CT
• Providers in Stamford, CT by specialty
• Surgical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.