Individual
ANTONIO B. LANDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
33 MOLLISON WAY, LEWISTON, ME 04240-5805
(207) 784-5782
(207) 786-5756
Mailing address
33 MOLLISON WAY, LEWISTON, ME 04240-5805
(207) 784-5782
(207) 783-9268
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-809
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267680099
—
ME
Enumeration date
04/10/2006
Last updated
01/23/2024
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