THERESA KORNELUK REILLY

Address: 2418 E Allegheny Ave, Philadelphia, PA 19134-4403
Phone: 2156346660

THERESA KORNELUK REILLY (NPI# 1700828472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1700828472
Entity Type 1 - Individual
Full Name THERESA KORNELUK REILLY
Credential M.D.
Practice Address 2418 E Allegheny Ave
Philadelphia
PA 19134-4403
Practice Telephone 2156346660
Practice Fax Number 2157396777
Enumeration Date 06/10/2006
Last Update Date 06/09/2010
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207W00000X Ophthalmology 020803E PA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
PA 0842013 05

Office Location

Street Address 2418 E ALLEGHENY AVE
City PHILADELPHIA
State PA
Zip Code 19134-4403

Providers with the same location

NPI Name Address
1831377746 THERESA K. REILLY MD OPT 2418 E Allegheny Ave, Philadelphia, PA 19134-4403

Competitor

Search similar physicians

City PHILADELPHIA
Zip Code 19134

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.