Provider Demographics
NPI:1740405505
Name:LANOY, REYNERIO SEPE (MD)
Entity Type:Individual
Prefix:
First Name:REYNERIO
Middle Name:SEPE
Last Name:LANOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:GARDINER
Mailing Address - State:ME
Mailing Address - Zip Code:04345-2620
Mailing Address - Country:US
Mailing Address - Phone:330-475-9976
Mailing Address - Fax:
Practice Address - Street 1:35 MEDICAL PARKWAY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330
Practice Address - Country:US
Practice Address - Phone:207-872-1270
Practice Address - Fax:207-872-1831
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.009175207R00000X
ME017527208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432691999Medicaid
ME432691999Medicaid
ME000235603Medicare PIN