MEDICARE: DOLCA THOMAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	215628	NY
2	207RN0300X	Nephrology Physician	215628	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144317215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOLCA THOMAS MD

Provider Business Mailing Address
First Line	:	73 RUTLAND RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-5312
Country	:	US
Telephone Number	:	347-687-7212
Fax Number	:

Provider Business Practice Location Address
First Line	:	73 RUTLAND RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-5312
Country	:	US
Telephone Number	:	347-687-7212
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	01/03/2011

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