Provider Demographics
NPI:1295784635
Name:REILLY, ANN E (MD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:E
Last Name:REILLY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:30 SOUTH VALLEY ROAD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1473
Mailing Address - Country:US
Mailing Address - Phone:610-296-0222
Mailing Address - Fax:610-296-3255
Practice Address - Street 1:30 SOUTH VALLEY ROAD
Practice Address - Street 2:SUITE 209
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1473
Practice Address - Country:US
Practice Address - Phone:610-296-0222
Practice Address - Fax:610-296-3255
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2020-03-27
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Provider Licenses
StateLicense IDTaxonomies
PAMD023144E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B35329Medicare UPIN
PA130913Medicare PIN