Provider Demographics
NPI:1699236265
Name:OREILLY, NADINE (PSYD)
Entity type:Individual
Prefix:DR
First Name:NADINE
Middle Name:
Last Name:OREILLY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07640-1215
Mailing Address - Country:US
Mailing Address - Phone:201-280-7230
Mailing Address - Fax:
Practice Address - Street 1:163 ENGLE STREET
Practice Address - Street 2:BUILDING 2, SECOND FLOOR
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631
Practice Address - Country:US
Practice Address - Phone:551-209-2069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00607900103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist