Provider Demographics
NPI:1912269457
Name:O'REILLY, BRIAN M (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:M
Last Name:O'REILLY
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:PO BOX 8519
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701
Mailing Address - Country:US
Mailing Address - Phone:732-460-9840
Mailing Address - Fax:732-460-9840
Practice Address - Street 1:4 HARTFORD DR. SUITE 1
Practice Address - Street 2:RIVERVIEW MEDICAL ASSOCIATES PA
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07701-4929
Practice Address - Country:US
Practice Address - Phone:732-741-3600
Practice Address - Fax:732-784-9171
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2016-11-02
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00436300363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology