Provider Demographics
NPI:1013928431
Name:DICOLA, VINCENT (MD, FACC, NASPE)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:DICOLA
Suffix:
Gender:M
Credentials:MD, FACC, NASPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 DEVINE STREET
Mailing Address - Street 2:SUITE #1
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473
Mailing Address - Country:US
Mailing Address - Phone:203-789-2272
Mailing Address - Fax:203-865-8614
Practice Address - Street 1:2 DEVINE STREET
Practice Address - Street 2:SUITE #1
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473
Practice Address - Country:US
Practice Address - Phone:203-789-2272
Practice Address - Fax:203-865-8614
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT020572207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001205723Medicaid
CT060019524OtherMEDICARE RAILROAD PIN
CTB39190Medicare UPIN
CT060019524Medicare PIN
CT060000277Medicare ID - Type Unspecified
CT001205723Medicaid
CT060001772Medicare PIN