Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 020572 | CT |
NPI | 1013928431 |
---|---|
Provider Name | Dr. Vincent Dicola |
First Address | North Haven, CT 06473 |
Second Address | North Haven, CT 06473 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 09/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001205723 | (05) | CT |
060019524 | MEDICARE RAILROAD PIN (01) | CT |
B39190 | (02) | CT |