Healthcare Provider Details

I. General information

NPI: 1205822012
Provider Name (Legal Business Name): RUFUS COLLEA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 NEW SCOTLAND AVE MAIL CODE 7
ALBANY NY
12208-3412
US

IV. Provider business mailing address

43 NEW SCOTLAND AVE MAIL CODE 7
ALBANY NY
12208-3412
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-6696
  • Fax: 518-262-6770
Mailing address:
  • Phone: 518-262-6696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number228083
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: