Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 125047836 | IL |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 238459 | MA |
N | 207YP0228X | Pediatric Otolaryngology | 0101247020 | VA |
N | 207YP0228X | Pediatric Otolaryngology | D0070469 | MD |
Y | 207YP0228X | Pediatric Otolaryngology | MD038620 | DC |
NPI | 1497911184 |
---|---|
Provider Name | Dr. Brian K Reilly |
First Address | Washington, DC 20010-2916 |
Second Address | Washington, DC 20010-2916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2008 |
Last Update Date | 02/03/2012 |