Healthcare Provider Details

I. General information

NPI: 1306942206
Provider Name (Legal Business Name): ANTHONY JOSEPH REINO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 MEMORIAL HWY SUITE 1-2
NEW ROCHELLE NY
10801-5635
US

IV. Provider business mailing address

175 MEMORIAL HWY SUITE 1-2
NEW ROCHELLE NY
10801-5635
US

V. Phone/Fax

Practice location:
  • Phone: 914-633-6375
  • Fax: 914-633-6359
Mailing address:
  • Phone: 914-633-6375
  • Fax: 914-633-6359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number175670
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number175670
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: