Provider Demographics
NPI:1114293115
Name:REILLY-KIT, KAITLIN JOHANNA (MD)
Entity Type:Individual
Prefix:DR
First Name:KAITLIN
Middle Name:JOHANNA
Last Name:REILLY-KIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:JOHANNA
Other - Last Name:REILLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:360 ESSEX ST.
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601
Mailing Address - Country:US
Mailing Address - Phone:551-996-8100
Mailing Address - Fax:
Practice Address - Street 1:360 ESSEX ST.
Practice Address - Street 2:SUITE 303
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601
Practice Address - Country:US
Practice Address - Phone:551-996-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-24
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2736612084A2900X, 2084N0400X
NJ25MA110475002084N0400X, 2084A2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology