Provider Demographics
NPI:1295388056
Name:O'REILLY-STANZILIS, LAURA (RN)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:O'REILLY-STANZILIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 WILLOW STREET
Mailing Address - Street 2:
Mailing Address - City:MOUNT ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07856
Mailing Address - Country:US
Mailing Address - Phone:646-251-6444
Mailing Address - Fax:
Practice Address - Street 1:31 WILLOW STREET
Practice Address - Street 2:
Practice Address - City:MOUNT ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07856
Practice Address - Country:US
Practice Address - Phone:646-251-6444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR14675200163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management