Provider Demographics
NPI:1851366496
Name:REIDY, JAMES JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:JOSEPH
Last Name:REIDY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4511 HARLEM RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3803
Mailing Address - Country:US
Mailing Address - Phone:716-929-4613
Mailing Address - Fax:716-839-6740
Practice Address - Street 1:3580 SHERIDAN DR
Practice Address - Street 2:SUITE 150
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1645
Practice Address - Country:US
Practice Address - Phone:716-881-7900
Practice Address - Fax:716-881-4349
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2010-05-12
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Provider Licenses
StateLicense IDTaxonomies
NY177988207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0806965OtherIHA
NY01167106Medicaid
NYA02572OtherEYEMED
NY01167106Medicaid
B65456Medicare UPIN