Provider Demographics
NPI:1477663888
Name:DE LOS HEROS, REINALDO (MD)
Entity Type:Individual
Prefix:DR
First Name:REINALDO
Middle Name:
Last Name:DE LOS HEROS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:367 US ROUTE 1
Mailing Address - Street 2:SUITE 3-1
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1350
Mailing Address - Country:US
Mailing Address - Phone:207-780-1600
Mailing Address - Fax:207-780-1608
Practice Address - Street 1:367 US ROUTE 1
Practice Address - Street 2:SUITE 3-1
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1350
Practice Address - Country:US
Practice Address - Phone:207-780-1600
Practice Address - Fax:207-780-1608
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME0172062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
D03371Medicare UPIN