Provider Demographics
NPI:1275848509
Name:O'REILLY, BLAIR (OD)
Entity Type:Individual
Prefix:DR
First Name:BLAIR
Middle Name:
Last Name:O'REILLY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 WORCESTER RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-2105
Mailing Address - Country:US
Mailing Address - Phone:508-943-9057
Mailing Address - Fax:
Practice Address - Street 1:56 WORCESTER RD UNIT B
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-2105
Practice Address - Country:US
Practice Address - Phone:508-943-9057
Practice Address - Fax:508-943-9057
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002601152W00000X
MA4836152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist