Provider Demographics
NPI:1871391748
Name:O'REILLY, EILISH (DPT)
Entity type:Individual
Prefix:
First Name:EILISH
Middle Name:
Last Name:O'REILLY
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 BRIARWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12542-6303
Mailing Address - Country:US
Mailing Address - Phone:845-236-2991
Mailing Address - Fax:
Practice Address - Street 1:33 RESEARCH WAY STE 9
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3489
Practice Address - Country:US
Practice Address - Phone:631-444-4240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053876225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist