Provider Demographics
NPI:1386889871
Name:REILLY, SHERRIE ANNE (PT)
Entity type:Individual
Prefix:
First Name:SHERRIE
Middle Name:ANNE
Last Name:REILLY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MT. MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510-1036
Mailing Address - Country:US
Mailing Address - Phone:585-658-2828
Mailing Address - Fax:585-245-5685
Practice Address - Street 1:1 COLLEGE CIR
Practice Address - Street 2:SUNY GENESEO- HOLCOMB BUILDING
Practice Address - City:GENESEO
Practice Address - State:NY
Practice Address - Zip Code:14454-1401
Practice Address - Country:US
Practice Address - Phone:585-245-5688
Practice Address - Fax:585-245-5685
Is Sole Proprietor?:No
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005345-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist