Healthcare Provider Details
I. General information
NPI: 1518952332
Provider Name (Legal Business Name): CAPITAL CARDIOLOGY ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/19/2005
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7 SOUTHWOODS BLVD
ALBANY NY
12211-2514
US
IV. Provider business mailing address
7 SOUTHWOODS BLVD
ALBANY NY
12211-2514
US
V. Phone/Fax
- Phone: 518-292-6000
- Fax: 518-292-6050
- Phone: 518-292-6000
- Fax: 518-292-6050
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0404X |
| Taxonomy | Cardiac Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
AUGUSTIN
J
DELAGO
Title or Position: CEO/PRESIDENT
Credential: MD
Phone: 518-292-6000