Reilly, Shannon B

Reilly, Shannon B is an individual health care provider with primary practice located at 5008 Brittonfield Pkwy Suite 700, East Syracuse NY 13057-9248. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Reilly, Shannon B can be contacted via phone (315) 472-7504.

Contact Information

Primary practice address
5008 Brittonfield Pkwy Suite 700 East Syracuse NY 13057-9248
Phone: (315) 472-7504
Fax: (315) 479-8639
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X F430268 New York

Profile Details

NPI number 1851370118
LBN Legal business name Reilly, Shannon B
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2006
Last updated Sep 19th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851370118 NPPES
New York MEDICAID 02648126

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