Jennifer Reilly

Individual provider Active NPI Licensed Practical Nurse · East Norwich, NY

NPI 1992340707 · NPPES record last updated Nov 15, 2019

Key facts

NPI
1992340707
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
332057 (NY)
Practice address
62 Sugar Toms Lane
East Norwich, NY 11732
Phone
(516) 805-3951
NPI assigned
Nov 15, 2019
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)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 332057 NY Yes

Addresses

Primary practice location

62 Sugar Toms Lane
East Norwich, NY 11732

Mailing address

62 Sugar Toms Lane
East Norwich, NY 11732

Other providers in East Norwich, NY

All providers in East Norwich, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.