Provider Demographics
NPI:1518952332
Name:CAPITAL CARDIOLOGY ASSOCIATES PLLC
Entity Type:Organization
Organization Name:CAPITAL CARDIOLOGY ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AUGUSTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DELAGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-292-6000
Mailing Address - Street 1:7 SOUTHWOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12211-2514
Mailing Address - Country:US
Mailing Address - Phone:518-292-6000
Mailing Address - Fax:518-292-6050
Practice Address - Street 1:7 SOUTHWOODS BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12211-2514
Practice Address - Country:US
Practice Address - Phone:518-292-6000
Practice Address - Fax:518-292-6050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac FacilitiesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110126737AMedicaid
FL914401300Medicaid
NY04598981Medicaid
MA9723960Medicaid
MACK7834OtherRR MEDICARE
VT1007470Medicaid
NYCJ6890OtherRR MEDICARE
VTCK8337OtherRR MEDICARE
NYAA1228Medicare PIN
MA110126737AMedicaid
NYWFL691Medicare PIN
VT002824Medicare PIN