Provider Demographics
NPI:1376651372
Name:DICOLA, JOSEPH L (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:L
Last Name:DICOLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HAYWARD ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2113
Mailing Address - Country:US
Mailing Address - Phone:508-431-3600
Mailing Address - Fax:508-431-2545
Practice Address - Street 1:2 HAYWARD ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2113
Practice Address - Country:US
Practice Address - Phone:508-431-3600
Practice Address - Fax:508-431-2545
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50587207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD050587OtherTUFTS
2506001OtherUHC
MAK02100OtherMABC
MA000000028129OtherBMC HEALTHNET
MA3081OtherHPHC
004405OtherRI BLUE CHIP
MAB10006609OtherCIGNA
MA110006965AMedicaid
MA33421OtherFALLON
MAA59492Medicare UPIN
MA110006965AMedicaid