Provider Demographics
NPI:1568434744
Name:REILLY, ANNE K (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:K
Last Name:REILLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:160 NORTH POINT BOULEVARD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601
Mailing Address - Country:US
Mailing Address - Phone:717-569-6481
Mailing Address - Fax:717-569-5213
Practice Address - Street 1:160 NORTH POINT BOULEVARD
Practice Address - Street 2:SUITE 110
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-569-6481
Practice Address - Fax:717-569-5213
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2007-10-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD068121L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2187048OtherAETNA HMO
PAG12079OtherHEALTH ASSURANCE
PA0017513250001Medicaid
PA5096057OtherAETNA NON-HMO
PAP002655OtherGATEWAY HEALTH PLAN
PA51684 S1BXOtherGEISINGER HEALTH PLAN
PA01897101OtherCAPITAL BLUE CROSS
PA1114681OtherAMERIHEALTH MERCY HEALTH
PA529015OtherHIGHMARK BLUE SHIELD
PA51684 S1BXOtherGEISINGER HEALTH PLAN
PA1114681OtherAMERIHEALTH MERCY HEALTH