Healthcare Provider Details

I. General information

NPI: 1245490283
Provider Name (Legal Business Name): JOHN CHARLES DALFINO JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 08/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 NEW SCOTLAND AVE MAIL CODE 10
ALBANY NY
12208-3412
US

IV. Provider business mailing address

43 NEW SCOTLAND AVE MAIL CODE 10
ALBANY NY
12208-3412
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-5300
  • Fax:
Mailing address:
  • Phone: 518-256-2818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number60254026
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: