Provider Demographics
NPI:1356562623
Name:OREILLY, DIANE ROSE (PTMS)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:ROSE
Last Name:OREILLY
Suffix:
Gender:F
Credentials:PTMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 STATE ROAD
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:PA
Mailing Address - Zip Code:16059-2140
Mailing Address - Country:US
Mailing Address - Phone:724-898-1421
Mailing Address - Fax:
Practice Address - Street 1:2581 WASHINGTON ROAD
Practice Address - Street 2:SUMMERFIELD COMMONS SUITE 235
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241
Practice Address - Country:US
Practice Address - Phone:800-355-1225
Practice Address - Fax:800-355-1114
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002647L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist