Provider Demographics
NPI:1982857876
Name:REILLY, BARBARA T (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:T
Last Name:REILLY
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 BRUNDIGE DR
Mailing Address - Street 2:
Mailing Address - City:GOLDENS BRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10526-1416
Mailing Address - Country:US
Mailing Address - Phone:914-232-3560
Mailing Address - Fax:
Practice Address - Street 1:40 BRUNDIGE DR
Practice Address - Street 2:
Practice Address - City:GOLDENS BRIDGE
Practice Address - State:NY
Practice Address - Zip Code:10526-1416
Practice Address - Country:US
Practice Address - Phone:914-232-3560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011079-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist