Basic Information
| Provider Information | |||||||||
| NPI: | 1376651372 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DICOLA | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 HAYWARD ST | ||||||||
| Address2: | |||||||||
| City: | ATTLEBORO | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027032113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5084313600 | ||||||||
| FaxNumber: | 5084312545 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 HAYWARD ST | ||||||||
| Address2: | |||||||||
| City: | ATTLEBORO | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027032113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5084313600 | ||||||||
| FaxNumber: | 5084312545 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2006 | ||||||||
| LastUpdateDate: | 09/12/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 50587 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 050587 | 01 | MD | TUFTS | OTHER | 2506001 | 01 | UHC | OTHER | K02100 | 01 | MA | MABC | OTHER | 000000028129 | 01 | MA | BMC HEALTHNET | OTHER | 3081 | 01 | MA | HPHC | OTHER | 004405 | 01 | RI BLUE CHIP | OTHER | B10006609 | 01 | MA | CIGNA | OTHER | 110006965A | 05 | MA | MEDICAID | 33421 | 01 | MA | FALLON | OTHER |