Provider Demographics
NPI:1841282878
Name:DAL COL, RICHARD H (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:H
Last Name:DAL COL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:116 EVERETT RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1427
Mailing Address - Country:US
Mailing Address - Phone:518-591-2240
Mailing Address - Fax:518-453-2245
Practice Address - Street 1:317 S MANNING BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1738
Practice Address - Country:US
Practice Address - Phone:518-591-2200
Practice Address - Fax:518-591-2222
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157778-1208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01281745Medicaid
NY33723PMedicare ID - Type Unspecified
NY01281745Medicaid