Eileen Reilly Diaz, P.T., R.N.

Individual provider Active NPI Physical Therapist · Upper Montclair, NJ

NPI 1376710012 · NPPES record last updated May 12, 2008

Key facts

NPI
1376710012
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
40QA00498800 (NJ)
Practice address
51 Oakwood Ave
Upper Montclair, NJ 07043-1916
Phone
(973) 744-1680
Fax
(973) 655-0971
NPI assigned
May 12, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA00498800 NJ Yes
Human Factors Physical Therapist 2251H1300X 40QA00498800 NJ

Addresses

Primary practice location

51 Oakwood Ave
Upper Montclair, NJ 07043-1916

Mailing address

51 Oakwood Ave
Upper Montclair, NJ 07043-1916
Phone (973) 744-1680

Other providers in Upper Montclair, NJ

All providers in Upper Montclair, NJ · Physical Therapist in New Jersey

Sources for this page

Verify at the official NPI Registry.