MEDICARE: RICHARD H DAL COL 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	157778-1	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	:	1841282878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD H DAL COL MD

Provider Business Mailing Address
First Line	:	116 EVERETT RD
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12205-1427
Country	:	US
Telephone Number	:	518-591-2240
Fax Number	:	518-453-2245

Provider Business Practice Location Address
First Line	:	317 S MANNING BLVD
Second Line	:	SUITE 240
City	:	ALBANY
State	:	NY
Zip	:	12208-1738
Country	:	US
Telephone Number	:	518-591-2200
Fax Number	:	518-591-2222

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	02/19/2008

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