Provider Demographics
NPI:1407899925
Name:REILLY, WILLIAM PETER II (PT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:PETER
Last Name:REILLY
Suffix:II
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 JOHN ST
Mailing Address - Street 2:309
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-2903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:274 MADISON AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0701
Practice Address - Country:US
Practice Address - Phone:212-732-1276
Practice Address - Fax:212-732-1328
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028146174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist