Individual provider · Type 1 NPI

Brent M. Reilly, PA-C

Surgical Physician Assistant · Bridgeport, CT

NPI number 1063586147 Active

Practice location

2800 Main St, St.vincents Multispecialty Group
Bridgeport, CT 06606-4201

Call (203) 576-6000 Map

Mailing address

6 Laurel Glen Dr
Shelton, CT 06484-3651

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X001824 (CT)
Surgical Physician Assistant Primary 363AS0400X001824 (CT)

Surgical Physician Assistant: Definition to come...

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About NPI 1063586147

Brent M. Reilly, PA-C's National Provider Identifier is 1063586147, issued on Nov 20, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Bridgeport, CT. The record was last updated on Sep 29, 2014.